Individual
JOHN MARCUS BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7946 GOODWOOD BLVD, BATON ROUGE, LA 70806-7629
(225) 590-3313
Mailing address
3409 PARKWAY DR, ALEXANDRIA, LA 71301-4031
(318) 955-2110
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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