Provider Demographics
NPI:1497881452
Name:DANCY, CONRAD B (DC)
Entity type:Individual
Prefix:DR
First Name:CONRAD
Middle Name:B
Last Name:DANCY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PARTRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4102
Mailing Address - Country:US
Mailing Address - Phone:407-365-7929
Mailing Address - Fax:407-365-1061
Practice Address - Street 1:758 N SUN DR
Practice Address - Street 2:SUITE 112
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2599
Practice Address - Country:US
Practice Address - Phone:407-804-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT95200Medicare UPIN
FL88217Medicare ID - Type Unspecified