Brockman, Marjorie A

Brockman, Marjorie A is an individual health care provider with primary practice located at 445 Idaho St , Gooding ID 83330-1258. She recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Other Service Providers / Acupuncturist. Chiropractic Providers / Chiropractor is her primary health care specialty. Brockman, Marjorie A can be contacted via phone (208) 934-5000.

Contact Information

Primary practice address
445 Idaho St Gooding ID 83330-1258
Phone: (208) 934-5000
Fax: (208) 934-5284
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CHIA-749 Idaho
Other Service Providers / Acupuncturist 171100000X ACC66 Idaho

Profile Details

NPI number 1861414138
LBN Legal business name Brockman, Marjorie A
Credentials R.N., D.C., C. AC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 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 1861414138 NPPES
Idaho Other 000010023081 BLUE SHIELD PROVIDER #
Idaho Other C-7499 BLUE SHIELD PROVIDER #

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