Provider Demographics
NPI:1740723824
Name:MEREDITH, BRITTANY SUNSHINE (DC)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:SUNSHINE
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:SUNSHINE
Other - Last Name:MCDONOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1380 MILAND ST
Mailing Address - Street 2:
Mailing Address - City:WOOD RIVER
Mailing Address - State:IL
Mailing Address - Zip Code:62095-3251
Mailing Address - Country:US
Mailing Address - Phone:618-558-1352
Mailing Address - Fax:
Practice Address - Street 1:1380 MILAND ST
Practice Address - Street 2:
Practice Address - City:WOOD RIVER
Practice Address - State:IL
Practice Address - Zip Code:62095-3251
Practice Address - Country:US
Practice Address - Phone:618-558-1352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013003111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor