Individual
PHILIP JOSEPH BRAZALOVICH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1824 PARKFORD LN, COLUMBUS, OH 43229-7084
(860) 712-8466
Mailing address
96 TALCOTT RD, GLASTONBURY, CT 06033-2919
(860) 712-8466
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
001143
CT
2255A2300X
Athletic Trainer
Primary
AT005382
OH
Other
Enumeration date
04/19/2017
Last updated
08/06/2020
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