Provider Demographics
NPI:1518027077
Name:BRIGNONI, NYLIAM NATALIA (DC)
Entity Type:Individual
Prefix:
First Name:NYLIAM
Middle Name:NATALIA
Last Name:BRIGNONI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615-B WADE HAMPTON BLVD.
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609
Mailing Address - Country:US
Mailing Address - Phone:864-567-9016
Mailing Address - Fax:864-292-0562
Practice Address - Street 1:1615-B WADE HAMPTON BLVD.
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609
Practice Address - Country:US
Practice Address - Phone:864-567-9016
Practice Address - Fax:864-292-0562
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor