Provider Demographics
NPI:1538146360
Name:BROOKS, DAVID LINDON (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LINDON
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 MADISON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3379
Mailing Address - Country:US
Mailing Address - Phone:540-825-5491
Mailing Address - Fax:540-825-6493
Practice Address - Street 1:767 MADISON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3379
Practice Address - Country:US
Practice Address - Phone:540-825-5491
Practice Address - Fax:540-825-6493
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000579111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350000548Medicare ID - Type Unspecified