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Individual

DR. DALE W BROCKMAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
6708 ODANA RD, MADISON, WI 53719-1066
(608) 826-9090
Mailing address
6708 ODANA RD, MADISON, WI 53719-1066
(608) 826-9090

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2219
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38798900
WI
01
391993582017
BCBS
WI
Enumeration date
02/24/2006
Last updated
07/09/2007
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