Organization
BROMENN PHYSICIAN MANAGEMENT CORPORATION
Active
Other names
ORTHOPEDIC SPORTS ENHANCEMENT CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM BROUWER (PRESIDENT,PHYSICIAN MGMNT CORP)
(309) 268-2129
Entity
Organization
Contact information
Practice address
2406 E EMPIRE ST, BLOOMINGTON, IL 61704-3630
(309) 663-9300
Mailing address
2406 E EMPIRE ST, BLOOMINGTON, IL 61704-3630
(309) 663-9300
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
10/28/2009
Last updated
10/28/2009
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