Provider Demographics
NPI:1487198487
Name:BROOKS SPINAL CARE PLLC
Entity Type:Organization
Organization Name:BROOKS SPINAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-587-7111
Mailing Address - Street 1:3314 E 46TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2926
Mailing Address - Country:US
Mailing Address - Phone:918-587-7111
Mailing Address - Fax:918-587-1177
Practice Address - Street 1:3314 E 46TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2926
Practice Address - Country:US
Practice Address - Phone:918-587-7111
Practice Address - Fax:918-587-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty