Individual
TIMOTHY ONEAL BROADDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
16985 W BLUEMOUND RD, BROOKFIELD, WI 53005-5909
(262) 641-8400
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2429-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38951100
—
WI
Enumeration date
10/18/2006
Last updated
05/31/2024
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