Individual
JESSICA LYNN BROADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARRT RT(R)(CT)(M)
Contact information
Practice address
12033 W AGENCY AVE, PARKER, AZ 85344
(928) 669-3379
Mailing address
3626 BEECHWOOD DR, LAKE HAVASU CITY, AZ 86406-7239
(573) 382-9704
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
31622
AZ
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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