Provider Demographics
NPI:1104661057
Name:BROOKS AND GILES DC, LLC
Entity type:Organization
Organization Name:BROOKS AND GILES DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-224-8599
Mailing Address - Street 1:2425 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3415
Mailing Address - Country:US
Mailing Address - Phone:706-534-2584
Mailing Address - Fax:706-354-0702
Practice Address - Street 1:997 COMMERCE DR SW STE 1A
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6647
Practice Address - Country:US
Practice Address - Phone:706-543-2584
Practice Address - Fax:706-354-0702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty