Provider Demographics
NPI:1376821496
Name:BRILLIANT, LAINA BEARD (DC)
Entity Type:Individual
Prefix:DR
First Name:LAINA
Middle Name:BEARD
Last Name:BRILLIANT
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 1:1241 S PARKER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2159
Mailing Address - Country:US
Mailing Address - Phone:303-745-6666
Mailing Address - Fax:303-745-4599
Practice Address - Street 1:1241 S PARKER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2159
Practice Address - Country:US
Practice Address - Phone:303-745-6666
Practice Address - Fax:303-745-4599
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor