Provider Demographics
NPI:1396281739
Name:HERBERT, BROOKE ASHLEY (DC)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ASHLEY
Last Name:HERBERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:ASHLEY
Other - Last Name:SKOWRONSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2561 UTE AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-7368
Mailing Address - Country:US
Mailing Address - Phone:520-373-4720
Mailing Address - Fax:
Practice Address - Street 1:2561 UTE AVE UNIT B
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-7368
Practice Address - Country:US
Practice Address - Phone:520-373-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34726111N00000X
MO2021034809111N00000X
WY851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor