Individual
EMMA PENELOPE BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 JAMES AVE, SAINT PAUL, MN 55105-2920
(651) 295-8536
Mailing address
1211 JAMES AVE, SAINT PAUL, MN 55105-2920
(651) 295-8536
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1791
MN
Other
Enumeration date
11/29/2017
Last updated
06/26/2019
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