Organization
DESEREE BRODDIE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DESEREE MARIE BRODDIE (LPN)
(229) 726-8253
Entity
Organization
Contact information
Practice address
128 STUBBS LN, BAINBRIDGE, GA 39817-1937
(229) 726-8253
Mailing address
128 STUBBS LN, BAINBRIDGE, GA 39817-1937
(229) 726-8253
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
LPN059350
GA
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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