Provider Demographics
NPI:1720381643
Name:BRINSON FAMILY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:BRINSON FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-847-4330
Mailing Address - Street 1:129 E VINCENNES ST
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-1859
Mailing Address - Country:US
Mailing Address - Phone:812-847-4330
Mailing Address - Fax:812-847-4073
Practice Address - Street 1:129 E VINCENNES ST
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-1859
Practice Address - Country:US
Practice Address - Phone:812-847-4330
Practice Address - Fax:812-847-4073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002418A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM100038585OtherMEDICARE PART B PTAN
INDR8348OtherRAILROAD MEDICARE PART B PTAN
IN201016540AMedicaid