Provider Demographics
NPI:1487815965
Name:BROX CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BROX CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-205-4138
Mailing Address - Street 1:95 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3965
Mailing Address - Country:US
Mailing Address - Phone:781-205-4138
Mailing Address - Fax:781-205-4140
Practice Address - Street 1:95 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3965
Practice Address - Country:US
Practice Address - Phone:781-205-4138
Practice Address - Fax:781-205-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty