Jake Broscha

NPI #1205216082 in Centerville, South Dakota

Provider Information

NPI Number: 1205216082
Entity Type: Individual
Name: Jake Broscha
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Jun 5, 2015
Last Updated: Jun 5, 2015

Practice Location

Address: 500 VERMILLION ST
City: Centerville
State: South Dakota
ZIP Code: 57014-2168
Phone: (605) 563-2251

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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