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Individual
ROGER O BRICK
Active
Individual
ROGER O BRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
003768
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04741014
BLUE CROSS BLUE SHIELD
MO
01
—
10001319001
COMMUNITY HEALTH CHP
MO
01
—
350000892
UNITED HEALTHCARE RAILROA
MO
01
—
5078241
AETNA
MO
Enumeration date
12/22/2006
Last updated
07/08/2007
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