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MRS. JAN M BROCKMAN PT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1497780472

Individual Registrant:
MRS. JAN M BROCKMAN PT
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5308 2ND AVE  PITTSVILLE, WI 54466 US
Tel: 715-884-2333  Fax: 715-884-2333

Contact information for business:
PO BOX 276  PITTSVILLE, WI 54466-0276 US
Tel: 715-884-2333  Fax: 715-884-2333

Registration Information:
NPI: 1497780472
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
WI4058-024

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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