| Philip Broesamle, | |
|
60 Mallory Ln., Shady Cove, OR 97539 | |
| (541) 878-2658 | |
| Not Available |
| Full Name | Philip Broesamle |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 60 Mallory Ln., Shady Cove, Oregon |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427444264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (NU) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Philip Broesamle, Po Box 323, Shady Cove, OR 97539 Ph: Not Available | Philip Broesamle, 60 Mallory Ln., Shady Cove, OR 97539 Ph: (541) 878-2658 |
Rhonda Grayson, Counselor Medicare: Accepting Medicare Assignments Practice Location: 95 Erickson Ave Unit 95a, Shady Cove, OR 97539 Phone: 541-630-4727 |
Ryan Stuart Price, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 21850 Highway 62 # 200, Shady Cove, OR 97539 Phone: 541-241-2105 |