Provider Demographics
NPI:1326125162
Name:GORMAN, BROOKE (DC)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:GORMAN
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 1:5935 S ZANG ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4647
Mailing Address - Country:US
Mailing Address - Phone:303-495-3210
Mailing Address - Fax:303-482-2234
Practice Address - Street 1:5935 S ZANG ST
Practice Address - Street 2:SUITE 250
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4647
Practice Address - Country:US
Practice Address - Phone:303-495-3210
Practice Address - Fax:303-482-2234
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU66429Medicare UPIN