Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC003541L | PA |
NPI | 1316992159 |
---|---|
Provider Name | Raymond William Brozek |
First Address | Doylestown, PA 18901-5513 |
Second Address | Doylestown, PA 18901-5513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 08/07/2007 |