Individual
SUSAN M BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
411 E IRELAND RD STE 400, SOUTH BEND, IN 46614-2681
(574) 561-8950
(574) 231-8955
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-6250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012405A
IN
225100000X
Physical Therapist
5501300653
MI
Other
Enumeration date
09/07/2012
Last updated
04/30/2019
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