Organization Name: | BROTHERTON FAMILY AND SPORTS CHIROPRACTIC P.C. |
NPI Number: | 1760726301 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMANDA BENGFORD (D.C.) |
Mailing Address: | 406 Main St Lake View |
State: | IA US |
Postal Code: | 514507710 |
Phone Number: | 7126654099 |
Fax Number: | |
NPI Enumeration Date: | 11/20/2012 |
NPI Last Update Date: | 08/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 007583 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |