Courtney L Broome, OT | |
15476b Dedeaux Rd, Gulfport, MS 39503-2637 | |
(228) 539-3232 | |
(228) 539-3230 |
Full Name | Courtney L Broome |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 15476b Dedeaux Rd, Gulfport, Mississippi |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407014137 | NPI | - | NPPES |
1033218524 | Other | MS | GROUP NPI |
C02726 | Other | MS | MEDICARE GROUP |
090-15385 | Medicaid | MS | |
256545 | Other | MS | MEDICARE PART A |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OT2180 (Mississippi) | Primary |
Mailing Address | Practice Location Address |
---|---|
Courtney L Broome, OT Po Box 8419, Biloxi, MS 39535-8087 Ph: (228) 388-5714 | Courtney L Broome, OT 15476b Dedeaux Rd, Gulfport, MS 39503-2637 Ph: (228) 539-3232 |
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