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General NPI Number Information
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NPI Number | 1427441146
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Entity Type | Individual
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Provider Name | FREDERICK VON BRINCKEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2015
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 338 E 4TH ST
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City | BENSON
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State | AZ
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Zip | 85602
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Country | US
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Telephone | 520-586-9364
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Fax | 520-586-1856
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Provider Business Mailing Address
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Address Line | 338 E 4TH ST
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City | BENSON
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State | AZ
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Zip | 85602-6614
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Country | US
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Telephone | 520-586-9364
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Fax | 520-586-1856
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4956
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License Number State | AZ
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