Individual
DR. JEFFREY L BROADHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3556 W 9800 S, SUITE 104, SOUTH JORDAN, UT 84095-3211
(801) 253-6590
(801) 253-6591
Mailing address
3556 W 9800 S, SUITE 104, SOUTH JORDAN, UT 84095-3211
(801) 253-6590
(801) 253-6591
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4826018-9934
UT
Other
Enumeration date
11/22/2005
Last updated
06/23/2015
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