Individual
BRANDI BROADDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
457 W MAIN ST, TRINIDAD, CO 81082-2623
(719) 846-3086
Mailing address
23500 US HIGHWAY 160 STE A, WALSENBURG, CO 81089-9524
(719) 738-4500
(719) 501-2580
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19454
CO
Other
Enumeration date
07/17/2012
Last updated
10/09/2023
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