Gary David Broom in Loves Park - Sports Physician
Gary David Broom - NPI 1881795870
Gary David Broom is a Sports Physician in Loves Park, Illinois. Gary David Broom practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for Gary David Broom is 1881795870. The last update date is 2009-03-31.
Gary David Broom's current location address is 1820 Windsor Rd, Loves Park, Illinois. You can contact this provider via phone number 8159864411 and fax number 8159864414. The mailing address for Gary David Broom is 1820 Windsor Rd, Loves Park, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary David Broom |
|---|---|
| Address | 1820 Windsor Rd, Loves Park, Illinois |
| Phone Number | 8159864411 |
| Fax Number | 8159864414 |
| Sole Proprietor | N |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1881795870 |
|---|---|
| Provider Enumeration Date | 2006-09-25 |
| Last Updated Date | 2009-03-31 |
Provider Mailing Address Detail
| Address | 1820 Windsor Rd |
|---|---|
| City | Loves Park |
| State | Illinois (IL) |
| Post Code | 611114271 |
| Phone Number | 8159864411 |
| Fax Number | 8159864414 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | 38008602 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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What is the unique 10-digit identification code assigned to Gary David Broom by the Centers for Medicare & Medicaid Services?
The Gary David Broom has been issued the NPI (National Provider Identifier) 1881795870, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Gary David Broom?
The Gary David Broom is situated at 1820 Windsor Rd, in the city of Loves Park, state of IL, with the zip code 611114271.
What is Gary David Broom's specialized field of practice, and what is the corresponding taxonomy classification code?
The Gary David Broom's area of specialization is Sports Physician, and the corresponding taxonomy code that categorizes this field of practice is 111Ns0005X.
On what date was the 1881795870 assigned to Gary David Broom?
The Gary David Broom was issued its 1881795870 on 2006-09-25, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Gary David Broom's details last updated?
The information pertaining to the Gary David Broom, including its address, specialty, and other details, was most recently updated on 2009-03-31.