Individual
MR. ROBERT W BRODDUS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1101 CAMDEN AVE, SALISBURY UNIVERSITY, SALISBURY, MD 21801-6837
(410) 543-6355
(410) 546-2639
Mailing address
124 DREXLER AVE S, LIVERPOOL, NY 13088-6634
(315) 382-8107
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0000758
MD
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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