REVAJO BROADWATER, PT

Physical Therapist

Active Individual
NPI: 1023111317

Practice Address

3537 NORTH CROSSING CIRCLE
Valdosta, GA 31602

Phone: (229) 333-0095

Specialties

Specialty Code Primary License
Physical Therapist 225100000X Yes 1473 (GA)

Frequently Asked Questions

NPI 1023111317 is the National Provider Identifier for REVAJO BROADWATER, PT, a Physical Therapist provider located in Valdosta, GA. This NPI was enumerated on September 5, 2006.
REVAJO BROADWATER, PT practices at 3537 NORTH CROSSING CIRCLE, Valdosta, GA 31602.

Quick Facts

NPI
1023111317
Type
Individual
Enumerated
Sep 5, 2006
Last Updated
Jul 8, 2007

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