Provider Demographics
NPI:1093174351
Name:BROGNA, KAREN (ATC,PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BROGNA
Suffix:
Gender:F
Credentials:ATC,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 SEDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-8658
Mailing Address - Country:US
Mailing Address - Phone:843-650-0820
Mailing Address - Fax:
Practice Address - Street 1:1428 SEDGEFIELD DR
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-8658
Practice Address - Country:US
Practice Address - Phone:843-650-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer