Individual
BROOKE ELIZABETH KEOSHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19401 NORTHLINE RD, SOUTHGATE, MI 48195-2277
(734) 785-7705
Mailing address
37431 CASTLE DR, ROMULUS, MI 48174-1013
(734) 558-5679
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/12/2021
Last updated
09/12/2021
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