Individual
MR. KYLE HENRY BROCKMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3 JERRY DR, LAKE HOPATCONG, NJ 07849-1416
(570) 228-1446
Mailing address
3 JERRY DR, LAKE HOPATCONG, NJ 07849-1416
(570) 228-1446
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01055300
NJ
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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