Individual
CASEY BROADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4580 PARADISE BLVD NW, ALBUQUERQUE, NM 87114-4105
(505) 823-8800
Mailing address
4580 PARADISE BLVD NW, ALBUQUERQUE, NM 87114-4105
(505) 823-8800
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006700
NM
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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