Dr Kenbroshddspc
Dr Kenbroshddspc is a Point of Service in Mascoutah, Illinois. Licensed in Illinois. Registered with an NPI since 2008.
- Licensed in
- IL
- In the registry since
- 2008
Practice location Address checks out
1180 N 6th StMascoutah, IL 62258-1178
Phone: (618) 566-7000
Fax: (618) 566-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Point of Service (primary) | Taxonomy 305S00000X · Licence 019019341 (IL) |
|---|
Record details
| NPI number | 1134399421 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ken Brosh — Pres. · (618) 566-7000 |
| NPI enumerated | March 3, 2008 |
| Last updated in NPPES | March 3, 2008 |
| Mailing address | 1180 N 6th St, Mascoutah, IL 62258-1178 |