Individual
DEANNA BROCARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2112 E DESERT LAKES DR, FORT MOHAVE, AZ 86426-6812
(562) 822-1198
Mailing address
2112 E DESERT LAKES DR, FORT MOHAVE, AZ 86426-6812
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9364A
AZ
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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