MEDICARE: BROOKS FAMILY CHIROPRACTIC CENTER LLC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1437806726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKS FAMILY CHIROPRACTIC CENTER LLC

Provider Business Mailing Address
First Line	:	1869 E MAIN ST STE B
Second Line	:
City	:	HOGANSVILLE
State	:	GA
Zip	:	30230-2787
Country	:	US
Telephone Number	:	706-637-1114
Fax Number	:	706-637-1124

Provider Business Practice Location Address
First Line	:	1869 E MAIN ST STE B
Second Line	:
City	:	HOGANSVILLE
State	:	GA
Zip	:	30230-2787
Country	:	US
Telephone Number	:	706-637-1114
Fax Number	:	706-637-1124

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. CHANTEL BROOKS
Credential	:	DC
Telephone Number	:	770-584-2126

Provider Enumeration Date	:	03/07/2022
Last Update Date	:	06/30/2022

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