Organization
DNA HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY DAVID BROOM (PRESIDENT)
(815) 986-4411
Entity
Organization
Contact information
Practice address
1820 WINDSOR RD, SUIT A, LOVES PARK, IL 61111-4271
(815) 986-4411
Mailing address
1820 WINDSOR RD, SUIT A, LOVES PARK, IL 61111-4271
(815) 986-4411
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
042619163
IL
111NS0005X
Sports Physician Chiropractor
042619163
IL
208D00000X
General Practice Physician
Primary
042619163
IL
Other
Enumeration date
10/30/2007
Last updated
03/31/2009
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