Provider Demographics
NPI:1114516333
Name:KORHAMMER, BROOKE (DC)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:KORHAMMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14453 WILLOW BEND PARK
Mailing Address - Street 2:
Mailing Address - City:TOWN AND COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8257
Mailing Address - Country:US
Mailing Address - Phone:636-489-9259
Mailing Address - Fax:
Practice Address - Street 1:930 KEHRS MILL RD STE 325-3
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2403
Practice Address - Country:US
Practice Address - Phone:636-489-9259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020038102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor