Provider Demographics
NPI:1821163197
Name:BRICKNER, DENNIS SCOTT (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:SCOTT
Last Name:BRICKNER
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 1:20 ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-1135
Mailing Address - Country:US
Mailing Address - Phone:937-748-4533
Mailing Address - Fax:937-748-4599
Practice Address - Street 1:20 ROYAL DR
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-1135
Practice Address - Country:US
Practice Address - Phone:937-748-4533
Practice Address - Fax:937-748-4599
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU10950Medicare UPIN
OH0657682Medicare ID - Type UnspecifiedMEDICARE NO.