Individual
MS. BROOKE M EWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1109 MACON DR, TITUSVILLE, FL 32780-7715
(321) 360-9467
Mailing address
1109 MACON DR, TITUSVILLE, FL 32780-7715
(321) 360-9467
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA55890
FL
Other
Enumeration date
03/01/2010
Last updated
03/01/2010
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