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Individual

ROGER O BRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
609 CLAY ST, CHILLICOTHE, MO 64601-2606
(660) 646-6044
(660) 646-6048
Mailing address
609 CLAY ST, CHILLICOTHE, MO 64601-2606
(660) 646-6044
(660) 646-6048

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
003768
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04741014
BLUE CROSS BLUE SHIELD
MO
01
10001319001
COMMUNITY HEALTH CHP
MO
01
350000892
UNITED HEALTHCARE RAILROA
MO
01
5078241
AETNA
MO
Enumeration date
12/22/2006
Last updated
07/08/2007
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