Cody O'neal Broom
NPI #1720738099 in Columbia, Mississippi
Provider Information
- NPI Number
- 1720738099
- Entity Type
- Individual
- Name
- Cody O'neal Broom
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapy Assistant
- Enumeration Date
- Mar 28, 2022
- Last Updated
- Jun 22, 2022
Practice Location
- Address
- 11 PECAN DR
- City
- Columbia
- State
- Mississippi
- ZIP Code
- 39429-2600
- Phone
- (601) 731-5717
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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