Individual
MR. KEVIN JOHN BROCHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
111 COLCHESTER AVE, FAHC EMERGENCY SERVICES, BURLINGTON, VT 05401-1473
(802) 847-1237
(802) 847-5963
Mailing address
76 SLATE BARN DR, WILLISTON, VT 05495-5344
(802) 879-2983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
55-0030269
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000288
—
VT
Enumeration date
07/11/2006
Last updated
08/09/2013
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