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1124020961
THOMAS BROCKHAUS
SIOUX CITY, IA
NPI
1124020961
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: IA 109914)
Enumeration Date
2005-08-11
Last Update Date
2008-04-29
Business Address
-- THOMAS BROCKHAUS CRNA
801 5TH ST
SIOUX CITY, IA 51101-1394
Phone number: 712-279-2505
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Mailing Address
-- THOMAS BROCKHAUS CRNA
400 E 10TH ST
WACONIA, MN 55387-4552
Phone number: 952-442-9770
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