Individual
CARLY MARIE BROHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6249
Mailing address
17 EDGEWOOD LN, SPENCER, WV 25276-1061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT003883
WV BOARD OF PHYSICAL THERAPY
WV
Enumeration date
06/23/2017
Last updated
11/03/2017
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