Individual
LISA JEAN BROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4345 ROUTE 136, GREENSBURG, PA 15601-6411
(724) 850-2607
Mailing address
1012 CICERO DR, IRWIN, PA 15642-6517
(724) 861-8440
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RT000805A
PA
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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