Mark Broccardo, COTA

NPI 1376215707 · on the registry since 2021

Practice

Address: 3430 Harrison Blvd
Ogden, UT 84403
Phone: (801) 399-5609
Fax: (801) 627-1808
Organisation at this address: Beaver Valley Hospital
Beaver Valley Hospital
Beaver Valley Hospital
De Moisy Healthcare, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 6

Registry record

Primary taxonomy: 224Z00000X
224Z00000X
Licence states on file: UT
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2021-10-04

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 Utah