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Individual

BRODERICK A BRASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
6440 MEDICAL CENTER ST STE 100, LAS VEGAS, NV 89148-2404
(702) 222-1000
(702) 222-9448
Mailing address
6440 MEDICAL CENTER ST STE 100, LAS VEGAS, NV 89148-2404
(702) 222-1000
(702) 222-9448

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3777
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3777
NV STATE LICENSE
NV
Enumeration date
08/15/2018
Last updated
08/15/2018
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