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Individual

TIMOTHY BROADBENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, PT

Contact information

Practice address
709 E MCCRACKEN RD, OZARK, MO 65721-9499
(417) 581-0468
Mailing address
709 E MCCRACKEN RD, OZARK, MO 65721-9499

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
107812
MO

Other

Enumeration date
04/29/2008
Last updated
04/29/2008
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