Individual
JOHN M BROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1012 CICERO DR, IRWIN, PA 15642-6517
(724) 610-1583
(724) 863-1256
Mailing address
1012 CICERO DR, IRWIN, PA 15642-6517
(724) 610-1583
(724) 863-1256
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
00000060
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000060
QRP
WV
Enumeration date
02/21/2010
Last updated
02/21/2010
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