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Individual

DR. REGINA P. BROCKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
3951 BARDSTOWN RD, SPRINGFIELD, KY 40069-8450
(859) 336-8446
Mailing address
PO BOX 327, SPRINGFIELD, KY 40069-0327
(859) 336-8446

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4174
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000256734
ANTHEM
KY
01
0269566
CIGNA
KY
01
1220237
NGS
KY
01
2448139000
PASSPORT ADVANTAGE
KY
01
50006949
PASSPORT HEALTH PLAN
KY
01
616822
ACN
KY
05
85003374
KY
Enumeration date
02/21/2007
Last updated
10/24/2011
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