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Individual

JOSHUA MICHAEL BRODERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
8100 NORTHLAND DR, BLOOMINGTON, MN 55431-4800
(906) 221-1181
Mailing address
15827 GRIFFON PATH, APPLE VALLEY, MN 55124-6661
(906) 221-1181

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3002
MN

Other

Enumeration date
03/02/2017
Last updated
04/30/2019
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