Individual
DR. RONNIE J. BOESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1000 BRADY ST, DAVENPORT, IA 52803-5214
(563) 884-5801
Mailing address
1000 BRADY ST, DAVENPORT, IA 52803-5214
(563) 884-5567
(563) 884-5740
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1188
TN
111N00000X
Chiropractor
2709
WI
111N00000X
Chiropractor
Primary
AO5801
IA
111NN0400X
Neurology Chiropractor
1999140067
MO
111NN0400X
Neurology Chiropractor
38009511
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07860
BLUE CROSS BLUE SHIELD
IA
Enumeration date
08/09/2005
Last updated
03/06/2014
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