Matt Brokaw, PTA

NPI #1871855155 in Kewanee, Illinois

Provider Information

NPI Number: 1871855155
Entity Type: Individual
Name: Matt Brokaw, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jun 12, 2012
Last Updated: Jun 12, 2012

Practice Location

Address: 300 TENNEY ST
City: Kewanee
State: Illinois
ZIP Code: 61443-3452
Phone: (309) 853-5500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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