Burdock, Edward M
Burdock, Edward M is an sole proprietor health care provider with primary practice located at 208 S Marion Ave , Washington IA 52353-1744. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Sports Physician. Chiropractic Providers / Sports Physician is his primary health care specialty. Burdock, Edward M can be contacted via phone (319) 653-3573.Contact Information
Primary practice address
208 S Marion Ave
Washington IA 52353-1744
Phone: (319) 653-3573
Fax: (319) 653-3573
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | A06120 | Iowa |
| Chiropractic Providers / Sports Physician | 111NS0005X | A06120 | Iowa |
Profile Details
| NPI number | 1417086760 |
|---|---|
| LBN Legal business name | Burdock, Edward M |
| Credentials | DC CCSP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 4th, 2007 |
| Last updated | Mar 26th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417086760 | NPPES |
| Iowa | Other | 45770 | WELLMARK BLUE CROSS BLUE |
| Iowa | MEDICAID | 0179408 | WELLMARK BLUE CROSS BLUE |
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