Provider Demographics
NPI:1982970059
Name:NIELSEN, BRETT CORTNEY (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:CORTNEY
Last Name:NIELSEN
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 1:28 HOLLOWS CT
Mailing Address - Street 2:
Mailing Address - City:LE CLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-8001
Mailing Address - Country:US
Mailing Address - Phone:309-752-3118
Mailing Address - Fax:
Practice Address - Street 1:28 HOLLOWS CT
Practice Address - Street 2:
Practice Address - City:LE CLAIRE
Practice Address - State:IA
Practice Address - Zip Code:52753-8001
Practice Address - Country:US
Practice Address - Phone:309-752-3118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor