Individual
BROOKE DELIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
103 GREENHAVEN RD, POUGHQUAG, NY 12570-5304
(845) 705-1092
Mailing address
103 GREENHAVEN RD, POUGHQUAG, NY 12570-5304
(845) 705-1092
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002328
NY
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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