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NPI Code Detail

MEDICARE: JARED MICHAEL BROSMER D.C.

MEDICARE:   JARED MICHAEL BROSMER  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor08001991AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000202113OTHERINANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588686778
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARED MICHAEL BROSMER D.C.
Provider Business Mailing Address
First Line : 1525 NEWTON ST
Second Line :
City : JASPER
State : IN
Zip : 47546-1622
Country : US
Telephone Number : 812-634-1977
Fax Number : 812-634-1977
Provider Business Practice Location Address
First Line : 1525 NEWTON ST
Second Line :
City : JASPER
State : IN
Zip : 47546-1622
Country : US
Telephone Number : 812-634-1977
Fax Number : 812-634-1977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 04/11/2008

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Directions to “ JARED MICHAEL BROSMER D.C.” Practice Location

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