Jeremy Broadhurst, DO

NPI #1114115664 in Providence, Utah

Provider Information

NPI Number: 1114115664
Entity Type: Individual
Name: Jeremy Broadhurst, DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: DO
Enumeration Date: Oct 10, 2007
Last Updated: Mar 5, 2012

Practice Location

Address: 190 S HIGHWAY 165
City: Providence
State: Utah
ZIP Code: 84332-9512
Phone: (435) 755-3300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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