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General NPI Number Information
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NPI Number | 1235506619
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Entity Type | Organization
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Legal Business Name | CHRIS MCBROOM, LLC
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 2225 HAMPTON PARK CT
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City | RENO
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State | NV
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Zip | 89521-5249
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Country | US
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Telephone | 775-315-5159
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Fax |
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Provider Business Mailing Address
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Address Line | 1065 S VIRGINIA ST
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City | RENO
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State | NV
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Zip | 89502-2417
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER PAUL MCBROOM
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Credential | DC
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Telephone | 775-315-5159
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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 | B01585
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License Number State | NV
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