Provider Demographics
NPI:1336368760
Name:BROOKS, ADAM MCKINLEY (DC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MCKINLEY
Last Name:BROOKS
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 1:8508A OHIO RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694
Mailing Address - Country:US
Mailing Address - Phone:740-574-9392
Mailing Address - Fax:
Practice Address - Street 1:8508A OHIO RIVER ROAD
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694
Practice Address - Country:US
Practice Address - Phone:740-574-9392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2530961Medicaid
OH2530961Medicaid