Individual
LAUNCE BRADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 AIRPORT RD, GRIFFIN, GA 30224-4834
(770) 227-8636
Mailing address
415 AIRPORT RD, GRIFFIN, GA 30224-4834
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA000794
GA
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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