Individual
KEVIN A BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-7514
(231) 392-0039
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-7514
(231) 392-0039
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004361
MI
Other
Enumeration date
12/11/2006
Last updated
07/05/2024
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