Provider Demographics
NPI:1285366476
Name:BRASS CHIROPRACTIC INCORPORATED
Entity type:Organization
Organization Name:BRASS CHIROPRACTIC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BRASS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-393-1722
Mailing Address - Street 1:21730 STEVENS CREEK BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-1171
Mailing Address - Country:US
Mailing Address - Phone:408-255-2592
Mailing Address - Fax:
Practice Address - Street 1:21730 STEVENS CREEK BLVD STE 102
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1171
Practice Address - Country:US
Practice Address - Phone:408-255-2592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty