Provider Demographics
NPI:1225220288
Name:FITZPATRICK, BRIAN JAMES (DC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WINDFLOWER LN
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SOLON
Mailing Address - State:IA
Mailing Address - Zip Code:52333-4709
Mailing Address - Country:US
Mailing Address - Phone:563-320-5007
Mailing Address - Fax:
Practice Address - Street 1:101 WINDFLOWER LN
Practice Address - Street 2:SUITE 800
Practice Address - City:SOLON
Practice Address - State:IA
Practice Address - Zip Code:52333-4709
Practice Address - Country:US
Practice Address - Phone:319-624-5145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor