Individual
PHILUSA CHUA MCBROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTDR/L
Contact information
Practice address
100B LINDSEY LANE, KINGSLAND, GA 31548
(912) 510-6104
(912) 882-6137
Mailing address
100B LINDSEY LANE, KINGSLAND, GA 31548
(912) 510-6104
(912) 882-6137
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
15996
FL
225X00000X
Occupational Therapist
Primary
OT005932
GA
Other
Enumeration date
10/09/2013
Last updated
06/17/2014
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