Individual
DAESEAN BROADWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
29706 EUCLID AVE, WICKLIFFE, OH 44092-1831
(330) 840-8002
Mailing address
29706 EUCLID AVE, WICKLIFFE, OH 44092-1831
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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