Broom, Gary David
Broom, Gary David is an individual health care provider with primary practice located at 1820 Windsor Rd Suit A, Loves Park IL 61111-4271. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Sports Physician. Chiropractic Providers / Chiropractor is his primary health care specialty. Broom, Gary David can be contacted via phone (815) 986-4411.Contact Information
Primary practice address
1820 Windsor Rd Suit A
Loves Park IL 61111-4271
Phone: (815) 986-4411
Fax: (815) 986-4414
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Chiropractic Providers / Chiropractor | 111N00000X | 038-008602 | Illinois |
Chiropractic Providers / Sports Physician | 111NS0005X | 038008602 | Illinois |
Profile Details
NPI number | 1881795870 |
---|---|
LBN Legal business name | Broom, Gary David |
Credentials | Doctor of Chiropractic (DC) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 25th, 2006 |
Last updated | Mar 31st, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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