Individual
MRS. KARIN MARIA VAN DEN BROECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
1220 LAGUNA ST, KOKOMO, IN 46902-2330
(765) 454-5340
(765) 454-5347
Mailing address
PO BOX 2496, KOKOMO, IN 46904-2496
(765) 454-5340
(765) 454-5347
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05005306A
IN
2251P0200X
Pediatric Physical Therapist
Primary
05005306A
IN
Other
Enumeration date
06/01/2010
Last updated
10/24/2012
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