Organization
BROAD WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DASHA HARDIN RD, LD (OWNER)
(850) 624-2583
Entity
Organization
Contact information
Practice address
4318 THRUSH CT, MARTINEZ, GA 30907-4415
(850) 624-2583
Mailing address
4318 THRUSH CT, MARTINEZ, GA 30907-4415
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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