Provider Demographics
NPI:1508379132
Name:SHEETS, BROC (DC)
Entity Type:Individual
Prefix:DR
First Name:BROC
Middle Name:
Last Name:SHEETS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 ELLIOTT DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1523
Mailing Address - Country:US
Mailing Address - Phone:765-432-8734
Mailing Address - Fax:
Practice Address - Street 1:1003 E 106TH ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46280-1423
Practice Address - Country:US
Practice Address - Phone:317-810-1013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002982A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor