Provider Demographics
NPI:1508163403
Name:BECK, BROOKE ASHLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ASHLEY
Last Name:BECK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:BROOKE
Other - Middle Name:ASHLEY
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:209 WALNUT COVE DR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2430
Mailing Address - Country:US
Mailing Address - Phone:724-986-5488
Mailing Address - Fax:
Practice Address - Street 1:578 FARRINGDOM ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2615
Practice Address - Country:US
Practice Address - Phone:910-739-5751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-12
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10236111N00000X
NC4356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor