Jerome Daniel Broderick in Grand Rapids - Physical Therapist
Jerome Daniel Broderick - NPI 1881691962
Jerome Daniel Broderick is a Physical Therapist in Grand Rapids, Michigan. Jerome Daniel Broderick practices all healthcare services and medical treatments related to Physical Therapist. The NPI Number for Jerome Daniel Broderick is 1881691962. The last update date is 2012-03-12.
Jerome Daniel Broderick's current location address is 2911 Knapp St Ne, Grand Rapids, Michigan. You can contact this provider via phone number 6169759078 and fax number 6169759248. The mailing address for Jerome Daniel Broderick is 2911 Knapp St Ne, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerome Daniel Broderick |
|---|---|
| Address | 2911 Knapp St Ne, Grand Rapids, Michigan |
| Phone Number | 6169759078 |
| Fax Number | 6169759248 |
| Sole Proprietor | N |
| Credentials | P.T. |
NPI Number Detail
| NPI Number | 1881691962 |
|---|---|
| Provider Enumeration Date | 2005-07-05 |
| Last Updated Date | 2012-03-12 |
Provider Mailing Address Detail
| Address | 2911 Knapp St Ne |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495254600 |
| Phone Number | 6169759078 |
| Fax Number | 6169759248 |
Provider's Primary Taxonomy Detail
| Speciality | Physical Therapist |
|---|---|
| Taxonomy | 225100000X |
| Licence No | 5501010335 |
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Definition: Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and per |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 650D113250 | MI | BLUE CROSS BLUE SHIELD ID | |
| P33049F | MI | BLUE CARE NETWORK ID | |
| JB010335 | MI | LISENCE NUMBER |
Post Comment/ Review Below
What is the unique identification code assigned to Jerome Daniel Broderick by the Centers for Medicare & Medicaid Services?
The Jerome Daniel Broderick has been issued the NPI (National Provider Identifier) 1881691962. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jerome Daniel Broderick?
The Jerome Daniel Broderick is situated at 2911 Knapp St Ne, in the city of Grand Rapids, state of MI, with the zip code 495254600.
What is Jerome Daniel Broderick's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Jerome Daniel Broderick is Physical Therapist, and the taxonomy code that categorizes this field of expertise is 225100000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1881691962 to Jerome Daniel Broderick?
The Centers for Medicare & Medicaid Services assigned the 1881691962 to Jerome Daniel Broderick on 2005-07-05.
As of what date were the details related to Jerome Daniel Broderick most recently updated or revised?
The information pertaining to Jerome Daniel Broderick, including its address, specialty, and other relevant details, was last updated or revised on 2012-03-12.
NPI Number: 1528061710
Address: 19 Nh Route 104, Meredith, NH