Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 11239 | TX |
NPI | 1619159985 |
---|---|
Provider Name | Dr. Amber Brooks |
First Address | Dallas, TX 75244-3522 |
Second Address | Dallas, TX 75244-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2007 |
Last Update Date | 11/05/2011 |