Provider Demographics
NPI:1265653901
Name:BROOKLINE CARE CENTER, INC.
Entity Type:Organization
Organization Name:BROOKLINE CARE CENTER, INC.
Other - Org Name:DR. FRAZEE FAMILY CHIROPRACTIC, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRILL
Authorized Official - Middle Name:S
Authorized Official - Last Name:FRAZEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-293-9345
Mailing Address - Street 1:1809 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6061
Mailing Address - Country:US
Mailing Address - Phone:405-293-9345
Mailing Address - Fax:405-293-9347
Practice Address - Street 1:1809 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-6061
Practice Address - Country:US
Practice Address - Phone:405-293-9345
Practice Address - Fax:405-293-9347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherCORPORATE TAX ID #