Individual
DR. LACY RAE FOLLETT-BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
105 E VEST ST, JEFFERSON, IA 50129-2752
(515) 386-4753
Mailing address
105 E VEST ST, JEFFERSON, IA 50129-2752
(515) 386-4753
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06459
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0285429
—
IA
01
—
30900
BLUE CROSS BLUE SHIELD
IA
Enumeration date
07/03/2006
Last updated
07/08/2007
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