Individual
STACY BROADHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3024 12TH AVE E, TUSCALOOSA, AL 35405-2506
(205) 562-9658
Mailing address
3024 12TH AVE E, TUSCALOOSA, AL 35405-2506
(205) 562-9658
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1563
AL
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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