Individual
MISS BROOKE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 W CIRCLE DR, EAST LANSING, MI 48824-3700
(269) 921-5541
Mailing address
918 E GRAND RIVER AVE APT 339, EAST LANSING, MI 48823-4583
(269) 921-5541
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J525098040848
MI
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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