Provider Demographics
NPI:1144305228
Name:DR DOROTHY B BROLIN DC PLLC
Entity type:Organization
Organization Name:DR DOROTHY B BROLIN DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:WYKEITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-388-9595
Mailing Address - Street 1:1300 SE MAYNARD RD
Mailing Address - Street 2:STE 202
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3602
Mailing Address - Country:US
Mailing Address - Phone:919-388-9595
Mailing Address - Fax:919-388-9596
Practice Address - Street 1:1300 SE MAYNARD RD
Practice Address - Street 2:STE 202
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3602
Practice Address - Country:US
Practice Address - Phone:919-388-9595
Practice Address - Fax:919-388-9596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890837RMedicaid
NC2454002Medicare PIN