Broome, Courtney L
Broome, Courtney L is an individual health care provider with primary practice located at 15476B Dedeaux Rd , Gulfport MS 39503-2637. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Broome, Courtney L can be contacted via phone (228) 539-3232.Contact Information
Primary practice address
15476B Dedeaux Rd
Gulfport MS 39503-2637
Phone: (228) 539-3232
Fax: (228) 539-3230
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OT2180 | Mississippi |
Profile Details
| NPI number | 1407014137 |
|---|---|
| LBN Legal business name | Broome, Courtney L |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 29th, 2008 |
| Last updated | May 29th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407014137 | NPPES |
| Mississippi | Other | 1033218524 | GROUP NPI |
| Mississippi | Other | C02726 | GROUP NPI |
| Mississippi | MEDICAID | 090-15385 | GROUP NPI |
| Mississippi | Other | 256545 | GROUP NPI |
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