Individual
MR. ROBERT R BROECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CCC-A
Contact information
Practice address
4650 W SPENCER ST, SUITE 31, APPLETON, WI 54914-9106
(920) 738-1819
Mailing address
1501 S CLARA ST, APPLETON, WI 54915-4061
(920) 213-0767
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
190-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41128800
—
WI
Enumeration date
07/16/2006
Last updated
06/08/2020
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