Organization
BROADWAY ERGONOMICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRET SHERIDAN DERRICK P.T. (PARTNER)
(573) 808-2392
Entity
Organization
Contact information
Practice address
111 E BROADWAY, SUITE 340, COLUMBIA, MO 65203-4208
(573) 808-2392
(888) 738-3034
Mailing address
111 E BROADWAY, SUITE 340, COLUMBIA, MO 65203-4208
(573) 808-2392
(888) 738-3034
Taxonomy
Speciality
Code
Description
License number
State
2251E1200X
Ergonomics Physical Therapist
02148
MO
2251X0800X
Orthopedic Physical Therapist
Primary
2010028179
MO
Other
Enumeration date
07/15/2012
Last updated
07/15/2012
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