Provider Demographics
NPI:1427023647
Name:BROWNRIDGE, DENNIS GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:GEORGE
Last Name:BROWNRIDGE
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 1:5015 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-7622
Mailing Address - Country:US
Mailing Address - Phone:517-887-2515
Mailing Address - Fax:517-887-3220
Practice Address - Street 1:5015 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-7622
Practice Address - Country:US
Practice Address - Phone:517-887-2515
Practice Address - Fax:517-887-3220
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDB002338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1000130Medicaid
MI950C312410OtherBLUE CROSS AND BLUE SHIELD OF MICHIGAN
MI1000130Medicaid