Individual
KATHLEEN ELIZABETH BROCKWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13740 BEACH BLVD STE 404, JACKSONVILLE, FL 32224-6036
(904) 223-5595
(904) 223-5594
Mailing address
13740 BEACH BLVD STE 404, JACKSONVILLE, FL 32224-6036
(904) 223-5595
(904) 223-5594
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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