Provider Demographics
NPI:1366412546
Name:BROUGHER, RHONDA LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:LYNN
Last Name:BROUGHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FLOYD
Mailing Address - State:IA
Mailing Address - Zip Code:50435-8092
Mailing Address - Country:US
Mailing Address - Phone:641-398-2341
Mailing Address - Fax:
Practice Address - Street 1:1068 RIVER RD
Practice Address - Street 2:
Practice Address - City:FLOYD
Practice Address - State:IA
Practice Address - Zip Code:50435-8092
Practice Address - Country:US
Practice Address - Phone:641-398-2341
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI1770Medicare ID - Type UnspecifiedPROVIDER