Individual
DR. IRIS A. BROSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 SIXTH AVE NO, CENTRA CARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5731
Mailing address
1200 SIXTH AVE NO, CENTRA CARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5731
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD043369E
PA
2084N0400X
Neurology Physician
Primary
51670
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001168197
—
PA
Enumeration date
02/03/2006
Last updated
06/17/2009
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