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Individual

MR. ROBERT HARRY BROCKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2311 AVENUE L STE 3, FORT MADISON, IA 52627-4031
(319) 372-3800
Mailing address
PO BOX 352, FORT MADISON, IA 52627-0352
(319) 372-3800

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04987
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10206
BCBS
IA
05
1218768
IA
Enumeration date
08/02/2005
Last updated
01/21/2010
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