Provider Demographics
NPI:1366205981
Name:LONIC, BROOKE ALEXANDRA (DC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ALEXANDRA
Last Name:LONIC
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7321 TAHITI RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3281
Mailing Address - Country:US
Mailing Address - Phone:423-834-2207
Mailing Address - Fax:
Practice Address - Street 1:7321 TAHITI RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-3281
Practice Address - Country:US
Practice Address - Phone:423-834-2207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor