Provider Demographics
NPI:1821119488
Name:BROOKS, DENNIS MCCREA (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MCCREA
Last Name:BROOKS
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N SUNRISE AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661
Mailing Address - Country:US
Mailing Address - Phone:916-782-4440
Mailing Address - Fax:916-782-1205
Practice Address - Street 1:151 N SUNRISE AVE STE 701
Practice Address - Street 2:BROOKS CHIROPRACTIC
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-782-4440
Practice Address - Fax:916-782-4440
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC011051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0110510Medicare ID - Type Unspecified