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General NPI Number Information
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NPI Number | 1730353285
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Entity Type | Organization
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Legal Business Name | BRIM CHIROPRACTIC LTD
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 900 W ROUTE 22 SUITE 160
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City | LAKE ZURICH
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State | IL
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Zip | 60047-3419
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Country | US
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Telephone | 847-726-2655
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Fax | 847-726-2654
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Provider Business Mailing Address
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Address Line | 900 W ROUTE 22 SUITE 160
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City | LAKE ZURICH
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State | IL
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Zip | 60047-3419
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Country | US
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Telephone | 847-726-2655
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Fax | 847-726-2654
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON BRIM
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Credential |
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Telephone | 847-726-2655
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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 |
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License Number State | IL
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