Organization
BRAEGEN ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMMIE JAGGARS L.S.A (OWNER)
(832) 881-8856
Entity
Organization
Contact information
Practice address
9451 E WINDING HILL AVE, LONE TREE, CO 80124
(832) 881-8856
(720) 294-0170
Mailing address
PO BOX 840967, HOUSTON, TX 77284-0967
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/06/2015
Last updated
07/09/2018
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