Healthcare Provider Details

I. General information

NPI: 1336245935
Provider Name (Legal Business Name): BRETT DAVID SPILLER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 N JERUSALEM RD
N BELLMORE NY
11710-1108
US

IV. Provider business mailing address

1860 N JERUSALEM RD
N BELLMORE NY
11710-1108
US

V. Phone/Fax

Practice location:
  • Phone: 516-554-8840
  • Fax: 516-706-8077
Mailing address:
  • Phone: 516-554-8840
  • Fax: 516-706-8077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX009726
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: