Individual
JOHN EDWARD BROOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
13224 SE 202ND RD, TALIHINA, OK 74571-5866
(918) 567-7000
(918) 567-2417
Mailing address
13224 SE 202ND RD, TALIHINA, OK 74571-5866
(918) 567-7000
(918) 567-2417
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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