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General NPI Number Information
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NPI Number | 1306116975
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Entity Type | Individual
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Provider Name | ALAN DAVID BROERING D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 110 S WYNSTONE PARK DR STE 105
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City | N BARRINGTON
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State | IL
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Zip | 60010-6979
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Country | US
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Telephone | 419-305-1377
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Fax |
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Provider Business Mailing Address
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Address Line | 110 S WYNSTONE PARK DR STE 105
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City | NORTH BARRINGTON
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State | IL
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Zip | 60010-6980
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Country | US
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Telephone | 419-305-1377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.012115
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License Number State | IL
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