Individual
DALE VANDER BROEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2 DEER RUN DR, PELLA, IA 50219-1356
(641) 780-1202
Mailing address
2 DEER RUN DR, PELLA, IA 50219-1356
(641) 780-1202
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02411
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110128512
RAILROAD MEDICARE
IA
05
—
2067256
—
IA
Enumeration date
03/16/2006
Last updated
05/14/2014
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