Individual
DALLAS BROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 N COLLEGE AVE, CLARKSVILLE, AR 72830-2880
Mailing address
415 N COLLEGE AVE, CLARKSVILLE, AR 72830-2880
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
854
AR
Other
Enumeration date
05/03/2019
Last updated
05/03/2019
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