MEDICARE: DR. BRITTANY MCMULLEN D. C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038012379	IL

General Provider Information

NPI Number	:	1629311261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRITTANY MCMULLEN D. C.

Provider Business Mailing Address
First Line	:	5898 PATHFINDER RD
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61109-4008
Country	:	US
Telephone Number	:	815-988-7831
Fax Number	:

Provider Business Practice Location Address
First Line	:	1752 WINDSOR RD STE 202
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61111-4276
Country	:	US
Telephone Number	:	815-977-3747
Fax Number	:	779-774-3282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2013
Last Update Date	:	10/08/2016

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