Individual
JUAQUINA MELITA BROUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR
Contact information
Practice address
4601 EAGLERIDGE PL STE 140, PUEBLO, CO 81008-4101
(719) 253-7727
(719) 253-7729
Mailing address
4601 EAGLERIDGE PL STE 140, PUEBLO, CO 81008-4101
(719) 253-7727
(719) 253-7729
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-3418
CO
Other
Enumeration date
04/05/2012
Last updated
12/28/2016
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