| Doctor Name: | CALLAN BRODERICK |
| NPI Number: | 1053732289 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 5460 Ward Rd Suite 300 Arvada, CO - 800021825 |
| Business Phone Number: | 3033517060 |
| Business Fax Number: | |
| Mailing Address: | 5460 Ward Rd, Suite 300 ARVADA |
| State: | CO |
| Postal Code: | 800021825 |
| Phone Number: | 3033517060 |
| Fax Number: | |
| NPI Enumeration Date: | 12/13/2013 |
| NPI Last Update Date: | 12/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZE0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | Electroneurodiagnostic |
| Taxonomy Definition: | |