Individual provider · Type 1 NPI

John Broderick

Student in an Organized Health Care Education/Training Program · Beavercreek, OH

NPI number 1154079499 Active

Practice location

725 University Blvd
Beavercreek, OH 45324-2640

Call (937) 343-4310 Map

Other practice locations

  • 5300 Far Hills Ave, Dayton, OH 45429-2381 · (937) 345-3226

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1154079499

John Broderick's National Provider Identifier is 1154079499, issued on Mar 15, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Beavercreek, OH. The record was last updated on Jun 3, 2026.