Provider Demographics
NPI:1053604710
Name:BRINK, DANIEL ADAMS (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ADAMS
Last Name:BRINK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-3620
Mailing Address - Country:US
Mailing Address - Phone:207-324-5753
Mailing Address - Fax:207-324-8354
Practice Address - Street 1:1047 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-3620
Practice Address - Country:US
Practice Address - Phone:207-324-5753
Practice Address - Fax:207-324-8354
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor