Provider Demographics
NPI:1235196114
Name:KOESTER, BRETT M (DC)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:M
Last Name:KOESTER
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 1:7346 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1904
Mailing Address - Country:US
Mailing Address - Phone:859-746-1511
Mailing Address - Fax:859-283-8672
Practice Address - Street 1:7346 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-746-1511
Practice Address - Fax:859-283-8672
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY250318111N00000X
KY4033111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor