Organization
BRADDOCK CHIROPRACTIC & FAMILY WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALEB BRADDOCK DC (OWNER)
(903) 482-1234
Entity
Organization
Contact information
Practice address
119 N MAIN ST, VAN ALSTYNE, TX 75495-1782
(903) 482-1232
Mailing address
PO BOX 1782, VAN ALSTYNE, TX 75495-1782
(903) 482-1234
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10170
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068PL
BCBS
TX
Enumeration date
05/05/2008
Last updated
09/23/2008
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