Individual
ETHELBERT BROADNAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
201 PINE GROVE CIR, DANIELS, WV 25832-9325
(304) 763-5191
Mailing address
201 PINE GROVE CIR, DANIELS, WV 25832-9325
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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