Individual
IVAN JAY BRODWYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3624 EDGEWOOD RD, COLUMBUS, GA 31907-2184
(706) 563-3370
(706) 563-3501
Mailing address
3624 EDGEWOOD RD, COLUMBUS, GA 31907-2184
(706) 563-3370
(706) 563-3501
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC1811
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7365
GRP NUMBER
GA
Enumeration date
07/10/2006
Last updated
01/15/2014
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