Individual
DEREK LEWIS BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
102 W MAPLE ST, SCOTTSVILLE, KY 42164-1134
(270) 239-6640
Mailing address
PO BOX 2697, BOWLING GREEN, KY 42102-7697
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007992
KY
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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