Provider Demographics
NPI:1417797614
Name:A&TBRESKECO, LLC
Entity type:Organization
Organization Name:A&TBRESKECO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRESKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-349-2884
Mailing Address - Street 1:10161 S PARKER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9603
Mailing Address - Country:US
Mailing Address - Phone:303-607-6066
Mailing Address - Fax:
Practice Address - Street 1:10161 S PARKER RD STE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9603
Practice Address - Country:US
Practice Address - Phone:303-607-6066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty