Individual
SHANNON P BROZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001910
IA
363AM0700X
Medical Physician Assistant
Primary
2531
WI
Other
Enumeration date
06/27/2008
Last updated
01/10/2014
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