| Doctor Name: | MR. ADAM G. BROAD |
| NPI Number: | 1427449826 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT |
| License Number: | PT023856 |
| Business Practice Address: | 5479 Pottsville Pike Suite 200 Leesport, PA - 195338650 |
| Business Phone Number: | 6109266778 |
| Business Fax Number: | 6109267200 |
| Mailing Address: | 415 36th St, Suite 100 PARKERSBURG |
| State: | WV |
| Postal Code: | 261011005 |
| Phone Number: | 3042023560 |
| Fax Number: | 3042023570 |
| NPI Enumeration Date: | 02/07/2015 |
| NPI Last Update Date: | 02/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT023856 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |