Provider Demographics
NPI:1669849386
Name:BURKHART, BRITTANY (DC)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:
Last Name:BURKHART
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 1:1145 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-3328
Mailing Address - Country:US
Mailing Address - Phone:951-235-4796
Mailing Address - Fax:
Practice Address - Street 1:3841 EMERALD AVE
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-2904
Practice Address - Country:US
Practice Address - Phone:909-301-0141
Practice Address - Fax:909-301-0141
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1649662891OtherGROUP/ORGANIZATION NPI