Individual
DR. JOHN P BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
174 CENTRAL STREET, SUITE 234, LOWELL, MA 01852
(978) 452-1466
(978) 452-1826
Mailing address
174 CENTRAL STREET, SUITE 234, LOWELL, MA 01852
(978) 452-1466
(978) 452-1826
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2553
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
351369
HARVARD PILGRIM
MA
01
—
468952
TUFTS
MA
01
—
606350
CIGNA
MA
01
—
63563
FALLON
MA
05
—
PR1697
—
MA
01
—
Y36807
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
10/04/2006
Last updated
07/08/2007
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