Larson, Brough, and Brockman Psc

NPI #1871543025 in Louisville, Kentucky

Provider Information

NPI Number: 1871543025
Entity Type: Organization
Organization Name: Larson, Brough, and Brockman Psc
Primary Specialty: Pediatrics
Enumeration Date: May 10, 2006
Last Updated: Aug 22, 2011

Practice Location

Address: 5109 NEW CUT RD
City: Louisville
State: Kentucky
ZIP Code: 40214-2745
Phone: (502) 361-1197

Authorized Official

Name: DANA L EVANS
Title: PROVIDER ENROLLMENT SPECIALIST
Phone: (270) 744-9600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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