Brockman, Dale W

Brockman, Dale W is an individual health care provider with primary practice located at 6708 Odana Rd , Madison WI 53719-1066. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Brockman, Dale W can be contacted via phone (608) 826-9090.

Contact Information

Primary practice address
6708 Odana Rd Madison WI 53719-1066
Phone: (608) 826-9090
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 2219 Wisconsin

Profile Details

NPI number 1710953120
LBN Legal business name Brockman, Dale W
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710953120 NPPES
Wisconsin MEDICAID 38798900
Wisconsin Other 391993582017

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