Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1385 | NC |
NPI | 1346264173 |
---|---|
Provider Name | Dr. Steven John Brodar |
First Address | Lexington, NC 27292-2840 |
Second Address | Lexington, NC 27292-2840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8908320 | (05) | NC |
T64557 | (02) | NC |