Individual
ANTOINETTE BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
2200 NE NEFF RD, SUITE 202, BEND, OR 97701-4283
(541) 388-7738
(541) 312-0121
Mailing address
PO BOX 24988, SEATTLE, WA 98124-0988
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
908779
OR
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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