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Individual

DR. LIANE MARISSA BROMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4021 S 700 E STE 300, SALT LAKE CITY, UT 84107-2184
(800) 453-3030
(800) 328-3091
Mailing address
2100 23RD AVE S, MINNEAPOLIS, MN 55404-3139
(612) 664-1151

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43609
MN

Other

Enumeration date
07/12/2006
Last updated
07/08/2007
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