Healthcare Provider Details

I. General information

NPI: 1437806726
Provider Name (Legal Business Name): BROOKS FAMILY CHIROPRACTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1869 E MAIN ST STE B
HOGANSVILLE GA
30230-2787
US

IV. Provider business mailing address

1869 E MAIN ST STE B
HOGANSVILLE GA
30230-2787
US

V. Phone/Fax

Practice location:
  • Phone: 706-637-1114
  • Fax: 706-637-1124
Mailing address:
  • Phone: 706-637-1114
  • Fax: 706-637-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHANTEL BROOKS
Title or Position: CHIROPRACTOR/OWNER
Credential: DC
Phone: 770-584-2126