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    This document contains personal information about Bennie Brewer who is applying for health insurance coverage through Blue Cross Blue Shield of Texas. It lists his name, address, contact information, family members, medical history of back and foot pain treated by doctors in Las Vegas, current medications, and previous health conditions from 2008-2011.

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    Chiropractor forms

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    This document contains personal information about Bennie Brewer who is applying for health insurance coverage through Blue Cross Blue Shield of Texas. It lists his name, address, contact information, family members, medical history of back and foot pain treated by doctors in Las Vegas, current medications, and previous health conditions from 2008-2011.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    3 views4 pages

    Chiropractor Forms

    Uploaded by

    brewerbat
    This document contains personal information about Bennie Brewer who is applying for health insurance coverage through Blue Cross Blue Shield of Texas. It lists his name, address, contact information, family members, medical history of back and foot pain treated by doctors in Las Vegas, current medications, and previous health conditions from 2008-2011.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 4

    10/2011 Bennie Brewer

    Husband
    Brewer Blue Cross Blue Shield of Texas

    Traci A 147485

    3368 Maxie Jones Rd


    Springfield
    TN 37172
    brewerbat@yahoo.com
    ✔ 60
    08/13/1960
    ✔

    Blue Cross Blue Shield of Texas

    Project Manager
    NGVi
    7201 W. Lake Mead Blvd
    Las Vegas, NV 89128
    629 518-3415
    Bennie Brewer
    07/23/1958
    Traci Brewer
    Mears Group
    04/1/2021

    629 305-6522 Husband

    629 231-6389

    Ben Brewer / Sabrina Dodd


    Husband / Daughter
    702 305-6522 Husband
    629 210-9018 Daughter

    Back and foot pain

    years ago

    8
    ✔ ✔ ✔

    ✔ ✔

    Most days
    Constant

    ✔ ✔
    ✔ ✔

    Dr. Wright (Chiropractor Las Vegas) Dr. Grover (back surgery Las vegas)

    1-2019

    1-2019

    10/2011
    object fell from top of shelf and hit me in the head 12/08 10/2011
    10/2011
    10/2011
    Back Surgery L4/L5 disks replaced 10/2011 10/2011

    morphin Vitamin d , mulit vitamin


    latex Calcium , Magnesium
    vision Shield
    Kroger White House loratadine
    629 omega

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