Provider Demographics
NPI:1366650301
Name:BRINKMAN CHIROPRACTIC CLINIC P.C.
Entity Type:Organization
Organization Name:BRINKMAN CHIROPRACTIC CLINIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-890-5640
Mailing Address - Street 1:372 CHANDLER ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-3300
Mailing Address - Country:US
Mailing Address - Phone:508-890-5640
Mailing Address - Fax:508-890-5641
Practice Address - Street 1:372 CHANDLER ST
Practice Address - Street 2:SUITE 201
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-3300
Practice Address - Country:US
Practice Address - Phone:508-890-5640
Practice Address - Fax:508-890-5641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1676261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU33040Medicare UPIN
MAY36206Medicare ID - Type Unspecified