Most Relevant Information
Provider Data
| NPI Number: | 1003274226 |
| Provider Name: | JESSICA NICOLE BROGAN LAT, ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | RT006253 |
Most Important Dates
| Enumeration Date: | 02/02/2016 |
| Last Updated: | 02/02/2016 |
Provider Practice Location
60 S LINCOLN ST
WASHINGTON
PA
153014812
Practice Location Phone/Fax
| Phone: | 5137037883 |
| Fax: |
Provider Mailing Location
523 MAPLE CREEK RD
MOSCOW
OH
451539718
Provider Mailing Phone/Fax
| Phone: | 5137037883 |
| Fax: |