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Shannon Broadie
NPI 1285811737 · on the registry since 2008 · sole proprietor
Practice
- Address
- 721 E Grand Ave
Ponca City, OK 74601 - Phone
- (580) 749-5139
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2008-03-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma