Individual
EMILEE BROADHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1628 19TH ST, LUBBOCK, TX 79401-4832
(806) 219-0500
(806) 766-1286
Mailing address
1628 19TH ST, LUBBOCK, TX 79401-4832
(806) 219-0500
(806) 766-1286
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
119692
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4386781-01
—
TX
Enumeration date
02/08/2019
Last updated
07/17/2024
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