Individual
DR. MICHAEL A BROSEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
317 E CARROL ST, KENTON, OH 43326-1539
(419) 673-1163
(419) 673-1163
Mailing address
317 E CARROL ST, KENTON, OH 43326-1539
(419) 673-1163
(419) 673-1163
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
876
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000130887
ANTHEM PROVIDER NUMBER
OH
05
—
0493685
—
OH
01
—
341353287-00
WORKER'S COMPENSATION
OH
Enumeration date
05/27/2005
Last updated
09/26/2023
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