Individual
ANN MICHELLE BRASE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
108 1ST ST E, MOUNT VERNON, IA 52314-1421
(319) 895-4085
(319) 895-8013
Mailing address
1501 PALISADES RD, MOUNT VERNON, IA 52314-9576
(319) 895-0718
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02412
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39797
BLUE CROSS BLUE SHEILD
IA
Enumeration date
01/18/2006
Last updated
07/08/2007
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