Organization
BROADWAY CHIROPRACTIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA JEAN ROGGE DC (OWNER)
(712) 322-8504
Entity
Organization
Contact information
Practice address
103 N AVENUE, SUITE 4, COUNCIL BLUFFS, IA 51503
(712) 322-8504
(402) 614-5823
Mailing address
103 N AVENUE, SUITE 4, COUNCIL BLUFFS, IA 51503
(712) 322-8504
(402) 614-5823
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04972
IA
Other
Enumeration date
05/02/2007
Last updated
10/02/2013
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