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1134399421
DR.KENBROSHDDSPC
MASCOUTAH, IL
NPI
1134399421
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Entity Type
Organization
Authorized Contact
KEN NEAL BROSH
Pres.
618-566-7000
Organization Subpart ?
No
Primary Taxonomy
305S00000X Point of Service
(Licence: IL 019019341)
Enumeration Date
2008-03-03
Last Update Date
2008-03-03
Business Address
DR.KENBROSHDDSPC
1180 N 6TH ST
MASCOUTAH, IL 62258-1178
Phone number: 618-566-7000
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Mailing Address
DR.KENBROSHDDSPC
1180 N 6TH ST
MASCOUTAH, IL 62258-1178
Phone number: 618-566-7000
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