Individual
CINDY BRODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1300 S COLUMBIA RD, GRAND FORKS, ND 58201
(701) 780-2300
(763) 689-5558
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
645
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
066R2BR
BLUE CROSS BLUE SHIELD
MN
01
—
15467
BLUE CROSS BLUE SHIELD
ND
05
—
54438
—
ND
05
—
616055700
—
MN
01
—
6411181
MEDICA
MN
Enumeration date
09/22/2006
Last updated
09/18/2018
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