Provider Demographics
NPI:1013039346
Name:BELLFIELD, BRIAN C (BRIAN BELLFIELD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:BELLFIELD
Suffix:
Gender:M
Credentials:BRIAN BELLFIELD
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:C
Other - Last Name:BELLFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BRIAN BELLFIELD DC
Mailing Address - Street 1:1316 VIVIAN ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3217
Mailing Address - Country:US
Mailing Address - Phone:303-651-1234
Mailing Address - Fax:303-651-9854
Practice Address - Street 1:1316 VIVIAN ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3217
Practice Address - Country:US
Practice Address - Phone:303-651-1234
Practice Address - Fax:303-651-9854
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor