Provider Demographics
NPI:1194019620
Name:L BROOKE HAWKINS DC LLC
Entity Type:Organization
Organization Name:L BROOKE HAWKINS DC LLC
Other - Org Name:HAWKINS HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-295-3346
Mailing Address - Street 1:211 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOOGOOTEE
Mailing Address - State:IN
Mailing Address - Zip Code:47553-1608
Mailing Address - Country:US
Mailing Address - Phone:812-295-3346
Mailing Address - Fax:
Practice Address - Street 1:211 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:LOOGOOTEE
Practice Address - State:IN
Practice Address - Zip Code:47553-1608
Practice Address - Country:US
Practice Address - Phone:812-295-3346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002538A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty