Susan Braddock

NPI #1528635141 in Fort Worth, Texas

Provider Information

NPI Number: 1528635141
Entity Type: Individual
Name: Susan Braddock
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Clinic/Center
Enumeration Date: Jun 10, 2021
Last Updated: Jun 10, 2021

Practice Location

Address: 2009 TREMONT AVE
City: Fort Worth
State: Texas
ZIP Code: 76107-3959
Phone: (817) 395-6284

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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