CLAY BURT BROADWELL

BISMARCK, ND
NPI1225868797
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy251S00000X Community/Behavioral Health
Enumeration Date2024-08-07
Last Update Date2024-08-07
Business Address
CLAY BURT BROADWELL
2130 S 12TH ST APT 137
BISMARCK, ND 58504-3144
Phone number: 701-840-1506
Mailing Address
CLAY BURT BROADWELL
2130 S 12TH ST APT 137
BISMARCK, ND 58504-3144
Phone number: 701-840-1506
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