Provider Demographics
NPI:1497173314
Name:BRIXTON INDIAN HILLS LLC
Entity Type:Organization
Organization Name:BRIXTON INDIAN HILLS LLC
Other - Org Name:BRIXTON CHIROPRACTIC & ACUPUNCTURE OF MOORE-NORMAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-413-5599
Mailing Address - Street 1:7304 N COMANCHE AVE
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-6635
Mailing Address - Country:US
Mailing Address - Phone:405-413-5599
Mailing Address - Fax:405-728-0443
Practice Address - Street 1:7304 N COMANCHE AVE
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73132-6635
Practice Address - Country:US
Practice Address - Phone:405-413-5599
Practice Address - Fax:405-728-0443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty