Individual
JEFFREY BROADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
720 GRACERN RD STE 115, COLUMBIA, SC 29210-7658
(803) 509-6256
Mailing address
703 N FANT ST STE A, ANDERSON, SC 29621-5705
(864) 622-0900
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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