Individual
BAILEY LYNN BROKMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
634 CENTER ST, BLACK EARTH, WI 53515-9544
(877) 252-4469
Mailing address
380 PANTHER CT, WHITEWATER, WI 53190-1566
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5856-27
WI
Other
Enumeration date
10/13/2019
Last updated
10/13/2019
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