Broaddus, Jack

Broaddus, Jack is an individual health care provider with primary practice located at 1200 S State St , Ann Arbor MI 48109. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Broaddus, Jack can be contacted via phone (734) 647-2583.

Contact Information

Primary practice address
1200 S State St Ann Arbor MI 48109
Phone: (734) 647-2583
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 2601002903 Michigan

Profile Details

NPI number 1134805096
LBN Legal business name Broaddus, Jack
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2023
Last updated Jun 26th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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