Individual
JOHN DAVID BOOMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
102 1ST ST SE, SPRING GROVE, MN 55974
(507) 498-5445
(507) 498-3577
Mailing address
13006 W BEAVER RD, SPRING GROVE, MN 55974-2463
(507) 498-5445
(507) 498-3577
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2367
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06952BO
BCBS PROVIDER NUMBER
MN
01
—
231665
CHIRO CARE OF MN PROV NO.
MN
Enumeration date
03/13/2007
Last updated
07/09/2007
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