Organization
JOHN H BROADDUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN HALE BROADDUS OD (OWNER)
(717) 393-4042
Entity
Organization
Contact information
Practice address
1158 PARK CITY CTR, LANCASTER, PA 17601-2726
(717) 393-4042
Mailing address
1158 PARK CITY CTR, LANCASTER, PA 17601-2726
(717) 393-4042
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001548
PA
Other
Enumeration date
09/16/2006
Last updated
10/30/2007
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