Organization
BROSSY-WATERWORKS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLEY BROSSY DO (OWNER)
(313) 216-0332
Entity
Organization
Contact information
Practice address
21031 MICHIGAN AVE FL 2, DEARBORN, MI 48124-2339
(313) 216-0332
(313) 216-0332
Mailing address
21031 MICHIGAN AVE FL 2, DEARBORN, MI 48124-2339
(313) 216-0332
(313) 216-0332
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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