Individual
EDWARD M BURDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC CCSP
Contact information
Practice address
208 S MARION AVE, WASHINGTON, IA 52353-1744
(319) 653-3573
(319) 653-3573
Mailing address
208 S MARION AVE, WASHINGTON, IA 52353-1744
(319) 653-3573
(319) 653-3573
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
A06120
IA
111NS0005X
Sports Physician Chiropractor
Primary
A06120
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0179408
—
IA
01
—
45770
WELLMARK BLUE CROSS BLUE
IA
Enumeration date
03/04/2007
Last updated
03/26/2009
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