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Dr. Jerald R Broderick, DC
Chiropractor in Elkhart, Indiana
NPI 1518923945

Jerald R Broderick is a Chiropractor based in Elkhart, IN. Jerald R Broderick practices in Elkhart, IN and has the professional credentials of DC. The NPI Number for Jerald R Broderick is 1518923945 and holds a License No. 306 (Indiana).

The current practice location address for Jerald R Broderick is 1424 Johnson St, Elkhart, IN and can be reached out via phone at 574-264-4151 and via fax at 574-262-9891.

Location: 1424 Johnson St, Elkhart, IN, 46514-3404
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518923945
Provider Name
Jerald R Broderick
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
1424 Johnson St, Elkhart, IN, 46514-3404
Phone Number
574-264-4151
Fax Number
574-262-9891
Provider Enumeration Date
04/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100112520A 05 IN
306 01 IN COMMERCIAL/WC/AA
000000084724 01 IN BLUE CROSS/BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1424 Johnson St
City
Elkhart
State
Indiana
Zip
46514-3404
Phone Number
574-264-4151
Fax Number
574-262-9891
person
Provider Business Mailing Address Details
Address
1424 Johnson St
City
Elkhart
State
Indiana
Zip
46514-3404
Phone Number
574-264-4151
Fax Number
574-262-9891
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
306 (Indiana)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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