Provider Demographics
NPI:1639930894
Name:BATES, BROOKLIN (DC)
Entity type:Individual
Prefix:DR
First Name:BROOKLIN
Middle Name:
Last Name:BATES
Suffix:
Gender:F
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:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-0215
Mailing Address - Country:US
Mailing Address - Phone:952-467-2505
Mailing Address - Fax:952-467-9104
Practice Address - Street 1:PO BOX 215
Practice Address - Street 2:
Practice Address - City:NORWOOD YOUNG AMERICA
Practice Address - State:MN
Practice Address - Zip Code:55368-0215
Practice Address - Country:US
Practice Address - Phone:952-484-4265
Practice Address - Fax:952-467-9104
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7174111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor