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General NPI Number Information
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NPI Number | 1700262508
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Entity Type | Individual
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Provider Name | BRETT BRODBECK D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 4260 STATE ROUTE 96
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City | BUCYRUS
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State | OH
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Zip | 44820-9388
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Country | US
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Telephone | 615-491-9094
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1538
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City | POWELL
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State | OH
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Zip | 43065-1538
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Country | US
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Telephone | 615-491-9094
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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 | 4549
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License Number State | OH
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