Individual
TRACY BROOMELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4025 CHERRY AVE NE, KEIZER, OR 97303-4859
(503) 390-9009
Mailing address
7614 RAVENSWOOD DR, PORTAGE, MI 49024-5020
(269) 501-8640
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501018836
MI
225100000X
Physical Therapist
Primary
62970
OR
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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