Provider Information for 1174634463
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Ms. MARSHA L BROERS MA
Sex: Female
NPI: 1174634463
Last Updated: 2008-07-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1174634463 | ||||||||
| Enumeration Date | 2006-08-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 33 E COLORADO AVE PRAIRIE BUILDING FRANKFORT, IL 60423-1385 United States Phone: 815-685-1225 | Fax:815-464-1289 | ||||||||
| Primary Practice Address | 33 E COLORADO AVE PRAIRIE BUILDING FRANKFORT, IL 60423-1385 United States Phone: 815-685-1225 | Fax:815-464-1289 | ||||||||
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