JACK BROADDUS

ANN ARBOR, MI
NPI1134805096
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MI  2601002903)
Enumeration Date2023-06-26
Last Update Date2023-06-26
Business Address
JACK BROADDUS ATC
1200 S STATE ST
ANN ARBOR, MI 48109
Phone number: 734-647-2583
Mailing Address
JACK BROADDUS ATC
11309 PORTER PIKE
OAKLAND, KY 42159
Phone number:
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