Individual
DR. ROGER CLARENCE HASBROUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
915 MADISON ST, BEAVER DAM, WI 53916-2623
(920) 887-8436
(920) 887-7399
Mailing address
915 MADISON ST, BEAVER DAM, WI 53916-2623
(920) 887-8436
(920) 887-7399
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1570
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38764000
—
WI
01
—
391363647010
BLUE CROSS BLUE SHIELD #
WI
Enumeration date
10/20/2006
Last updated
07/09/2007
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