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Contact Information

ELLIOT D BROADHEAD, DPT
527 5TH AVE #500
SHEPPARD AFB, TX76311
 Phone: 208-828-4626
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for ELLIOT D BROADHEAD · (Male)

NPI Number 1255996468
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 05/02/2019
Last updated 09/18/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • ID License # 5817
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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