Individual
MRS. JESSICA POLK BRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
237 W MAIN ST, AZLE, TX 76020-3177
(817) 444-2170
(817) 270-3338
Mailing address
237 W MAIN ST, AZLE, TX 76020-3177
(817) 444-2170
(817) 270-3338
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9732
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8R3130
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/30/2006
Last updated
12/03/2007
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