Healthcare Provider Details

I. General information

NPI: 1861470536
Provider Name (Legal Business Name): ANDRIA L BROOKS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 08/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 HIGHWAY 81 N
CALHOUN KY
42327-9782
US

IV. Provider business mailing address

344 STATE HWY 81 N
CALHOUN KY
42327
US

V. Phone/Fax

Practice location:
  • Phone: 270-273-5122
  • Fax: 270-273-9790
Mailing address:
  • Phone: 270-273-5122
  • Fax: 270-273-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4935
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: