Individual
DIANE BROADDUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
55 GREEN HILL RD, BELLINGHAM, WA 98229-7718
(859) 339-9838
Mailing address
55 GREEN HILL RD, BELLINGHAM, WA 98229-7718
(859) 339-9838
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
107950
KY
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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