Individual
MS. BROOKE HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, OTC
Contact information
Practice address
1200 CONSTITUTION AVE, SUITE 110, PHILADELPHIA, PA 19112-1329
(609) 204-0627
Mailing address
1200 CONSTITUTION AVE, SUITE 110, PHILADELPHIA, PA 19112-1329
(609) 204-0627
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT005550
PA
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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