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Individual

COREY ELIZABETH BROM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
120 GATEWAY CORPORATE BLVD, COLUMBIA, SC 29203-9611
(803) 865-4500
Mailing address
221 RIVERVIEW TER, LAKE WYLIE, SC 29710-8964

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5055
SC
363AM0700X
Medical Physician Assistant
SC

Other

Enumeration date
11/21/2023
Last updated
02/17/2025
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