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NPI Code Detail

MEDICARE: JOLYNN BRUBAKER SLPA

MEDICARE: JOLYNN BRUBAKER SLPA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225500000XRespiratory/Developmental/Rehabilitative Specialist/Technologist

General Provider Information

NPI Number : 1437402302
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOLYNN BRUBAKER SLPA
Provider Business Mailing Address
First Line : 200 VISTA DR
Second Line :
City : COLDWATER
State : MI
Zip : 49036-1776
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 VISTA DR
Second Line :
City : COLDWATER
State : MI
Zip : 49036-1776
Country : US
Telephone Number : 517-278-5933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2012
Last Update Date : 10/17/2012

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Directions to “ JOLYNN BRUBAKER SLPA” Practice Location

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