Individual
BROOKE BOESER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
231 W MAIN ST, SAINT JACOB, IL 62281-1531
(618) 225-9212
Mailing address
231 W MAIN ST, SAINT JACOB, IL 62281-1531
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004890
IL
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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