Provider Demographics
NPI:1912729179
Name:BRANDON R MCKENZIE DC PLLC
Entity type:Organization
Organization Name:BRANDON R MCKENZIE DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-242-6038
Mailing Address - Street 1:39949 GARFIELD RD STE B
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4301
Mailing Address - Country:US
Mailing Address - Phone:586-286-1112
Mailing Address - Fax:
Practice Address - Street 1:39949 GARFIELD RD STE B
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-4301
Practice Address - Country:US
Practice Address - Phone:586-286-1112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty