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General NPI Number Information
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NPI Number | 1639930894
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Entity Type | Individual
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Provider Name | BROOKLIN BATES D.C.
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Gender | Female
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | PO BOX 215
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City | NORWOOD YOUNG AMERICA
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State | MN
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Zip | 55368-0215
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Country | US
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Telephone | 952-484-4265
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Fax | 952-467-9104
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Provider Business Mailing Address
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Address Line | PO BOX 215
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City | CHANHASSEN
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State | MN
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Zip | 55317-0215
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Country | US
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Telephone | 952-467-2505
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Fax | 952-467-9104
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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 | 7174
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License Number State | MN
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