| NPI | 1750367256 |
|---|---|
| Other Name | CHUCK BROCKMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 3101) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 1653) |
| 225100000X Physical Therapist (Licence: NV 912) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2012-11-01 |