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Russell David Broccoli, DC
Chiropractor in Providence, Rhode Island
NPI 1689740607

Russell David Broccoli is a Chiropractor based in Providence, RI. Russell David Broccoli practices in Providence, RI and has the professional credentials of DC. The NPI Number for Russell David Broccoli is 1689740607 and holds a License No. DCP00204 (Rhode Island).

The current practice location address for Russell David Broccoli is 635 Hope Street, Providence, RI and can be reached out via phone at 401-351-6390 and via fax at 401-331-0614.

Location: 635 Hope Street, Providence, RI, 02906
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Provider Profile Details
NPI Number
1689740607
Provider Name
Russell David Broccoli
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
635 Hope Street, Providence, RI, 02906
Phone Number
401-351-6390
Fax Number
401-331-0614
Provider Enumeration Date
11/28/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
90476 01 RI BCBS
204088 01 RI BLUE CHIP
institution
Provider Business Practice Location Address Details
Address
635 Hope Street
City
State
Zip
02906
Phone Number
401-351-6390
Fax Number
401-331-0614
person
Provider Business Mailing Address Details
Address
635 Hope Street
City
State
Zip
02906
Phone Number
401-351-6390
Fax Number
401-331-0614
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
License No.
DCP00204 (Rhode Island)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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