BROADWAY CHIROPRACTIC CLINIC PC NPI 1275755092

NPI Information

  • NPI: 1275755092
  • Provider Name: BROADWAY CHIROPRACTIC CLINIC PC
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Organization
  • Address: 103 N AVENUE
    SUITE 4
    COUNCIL BLUFFS, IA
    ZIP 51503
  • Phone: (712) 322-8504

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NPI Details

BROADWAY CHIROPRACTIC CLINIC PC is a chiropractor in Council Bluffs, IA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. BROADWAY CHIROPRACTIC CLINIC PC NPI is 1275755092. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

103 N AVENUE
SUITE 4
COUNCIL BLUFFS, IA
ZIP 51503
Phone: (712) 322-8504
Fax: (402) 614-5823

The provider's authorized official is Deanna Jean Rogge .
The authorized official title is Owner and has the following contact phone number (712) 322-8504.

The enumeration date for this NPI number is 5/2/2007 and was last updated on 10/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor04972IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
120218MEDICARE ID-TYPE UNSPECIFIEDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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