Individual
KEVIN STANLEY BROADDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6739 W CACTUS RD, PEORIA, AZ 85381-5311
(833) 242-0100
(602) 805-4745
Mailing address
3149 E HAZELTINE WAY, CHANDLER, AZ 85249-9066
(414) 702-0954
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD-000814
AZ
Other
Enumeration date
08/05/2006
Last updated
08/11/2023
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