Doctor Name: | MARJORIE A BROCKMAN |
NPI Number: | 1861414138 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N., D.C., C. AC |
License Number: | CHIA-749 |
Business Practice Address: | 445 Idaho St Gooding, ID - 833301258 |
Business Phone Number: | 2089345000 |
Business Fax Number: | 2089345284 |
Mailing Address: | 445 Idaho St, GOODING |
State: | ID |
Postal Code: | 833301258 |
Phone Number: | 2089345000 |
Fax Number: | 2089345284 |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CHIA-749 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | ID |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |