Provider Demographics
NPI:1609043058
Name:DENNIS G BROWNRIDGE D C P C
Entity type:Organization
Organization Name:DENNIS G BROWNRIDGE D C P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:BROWNRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-887-2515
Mailing Address - Street 1:5015 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-7622
Mailing Address - Country:US
Mailing Address - Phone:517-887-2515
Mailing Address - Fax:517-887-3220
Practice Address - Street 1:5015 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-7622
Practice Address - Country:US
Practice Address - Phone:517-887-2515
Practice Address - Fax:517-887-3220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDB002338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950C312410OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI950C312410OtherBLUE CROSS BLUE SHIELD OF MICHIGAN