Provider Demographics
NPI:1952865362
Name:BRILL, CALEB (DC)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:BRILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11815 S SHANNAN ST APT 214
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3689
Mailing Address - Country:US
Mailing Address - Phone:620-440-0627
Mailing Address - Fax:
Practice Address - Street 1:1800 WYANDOTTE ST STE 201
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-1902
Practice Address - Country:US
Practice Address - Phone:816-605-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019000925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor