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General NPI Number Information
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NPI Number | 1033218995
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Entity Type | Organization
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Legal Business Name | BROOKFIELD FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 499 FEDERAL RD UNIT #18
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City | BROOKFIELD
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State | CT
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Zip | 06804-2041
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Country | US
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Telephone | 203-775-7102
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Fax | 203-775-6843
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Provider Business Mailing Address
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Address Line | 499 FEDERAL RD UNIT #18
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City | BROOKFIELD
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State | CT
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Zip | 06804-2041
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Country | US
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Telephone | 203-775-7102
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Fax | 203-775-6843
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | MICHAEL ZSCHUNKE
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Credential |
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Telephone | 203-775-7102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 001363
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License Number State | CT
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