Provider Demographics
NPI:1033218995
Name:BROOKFIELD FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BROOKFIELD FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZSCHUNKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-775-7102
Mailing Address - Street 1:499 FEDERAL RD
Mailing Address - Street 2:UNIT #18
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2041
Mailing Address - Country:US
Mailing Address - Phone:203-775-7102
Mailing Address - Fax:203-775-6843
Practice Address - Street 1:499 FEDERAL RD
Practice Address - Street 2:UNIT #18
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2041
Practice Address - Country:US
Practice Address - Phone:203-775-7102
Practice Address - Fax:203-775-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT71633OtherCONNECTICARE
CT6811432002OtherCIGNA
CT7417203OtherAETNA
CTP2521445OtherOXFORD
CT050001363CT01OtherANTHEM