Individual
CARLY ANNE BROCHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3802 EASTSIDE HWY, STEVENSVILLE, MT 59870-2224
(406) 777-3523
Mailing address
3970 MULLAN RD APT 401, MISSOULA, MT 59808-5584
(651) 353-9237
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT60774080
WA
225100000X
Physical Therapist
Primary
PTP-PT-LIC-15223
MT
Other
Enumeration date
08/30/2017
Last updated
09/18/2019
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