NPI | 1700350709 |
---|---|
Former Name | ERYN MCCALL BRADDOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1997) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 14006) |
Enumeration Date | 2019-01-14 |
Last Update Date | 2024-12-31 |