Individual
MR. MICHAEL BROADBENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
4712 CHESTER AVE, PHILADELPHIA, PA 19143-3513
(215) 727-4450
Mailing address
36 WOODLANE DR, BLACKWOOD, NJ 08012-4507
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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