Colin Michael Broderick, PA-C

NPI #1982089066 in Rockford, Illinois

Provider Information

NPI Number: 1982089066
Entity Type: Individual
Name: Colin Michael Broderick, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jul 30, 2015
Last Updated: May 18, 2023

Practice Location

Address: 5875 E RIVERSIDE BLVD
City: Rockford
State: Illinois
ZIP Code: 61114-4937
Phone: (815) 398-9491

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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