Individual
JESSICA ANN BRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4495 ROOSEVELT BLVD, SUITE #317, JACKSONVILLE, FL 32210-3375
(904) 384-4415
(904) 384-4212
Mailing address
540 KINGSLEY AVE, ORANGE PARK, FL 32073-4830
(904) 264-2156
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA21789
FL
Other
Enumeration date
02/15/2010
Last updated
02/15/2010
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