NPI 1518713064

Jeffrey Broadwell, CPO

Practitioner Prosthetist Columbia, SC

Practice location

Address: 720 Gracern Rd STE 115, Columbia, SC 29210-7658
Phone: (803) 509-6256
Mailing address: 703 N Fant St STE a, Anderson, SC 29621-5705

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Registry record

NPI: 1518713064
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Apr 2024
Record last updated: 25 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.