Provider Demographics
NPI:1528448685
Name:KASPRACK, BRITTANY (DC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:KASPRACK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6942 AUTUMN OAKS DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-9379
Mailing Address - Country:US
Mailing Address - Phone:662-890-0012
Mailing Address - Fax:662-890-0522
Practice Address - Street 1:3615 S HOUSTON LEVEE RD
Practice Address - Street 2:STE 110
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-9192
Practice Address - Country:US
Practice Address - Phone:901-221-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1245111N00000X
TN2859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor