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NPI Code Detail

MEDICARE: KAYLEE BRABHAM DC

MEDICARE: KAYLEE BRABHAM DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor6242OR

General Provider Information

NPI Number : 1417671090
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEE BRABHAM DC
Provider Business Mailing Address
First Line : 2214 NE MCDONALD LN
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-2702
Country : US
Telephone Number : 503-434-6603
Fax Number :
Provider Business Practice Location Address
First Line : 2214 NE MCDONALD LN
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-2702
Country : US
Telephone Number : 503-434-6603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2022
Last Update Date : 09/28/2022

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Directions to “ KAYLEE BRABHAM DC” Practice Location

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