Individual
JAKE BROSCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 VERMILLION ST, CENTERVILLE, SD 57014-2168
(605) 563-2251
Mailing address
805 E 15TH ST APT 304, YANKTON, SD 57078-5010
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0430
SD
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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