Individual
DR. BRIAN DICKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4436 CORRALES RD, CORRALES, NM 87048-8608
(505) 738-6897
Mailing address
PO BOX 2057, CORRALES, NM 87048-2057
(505) 738-6897
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2164
NM
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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