Individual
JESSICA NICOLE BROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
60 S LINCOLN ST, WASHINGTON, PA 15301-4812
(513) 703-7883
Mailing address
523 MAPLE CREEK RD, MOSCOW, OH 45153-9718
(513) 703-7883
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT006253
PA
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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