Provider Demographics
NPI:1538285846
Name:BROOKSVILLE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BROOKSVILLE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-799-3433
Mailing Address - Street 1:813 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-3106
Mailing Address - Country:US
Mailing Address - Phone:352-799-3433
Mailing Address - Fax:352-799-3320
Practice Address - Street 1:813 S BROAD ST
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-3106
Practice Address - Country:US
Practice Address - Phone:352-799-3433
Practice Address - Fax:352-799-3320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV08574Medicare UPIN
FLAC427Medicare PIN