Individual
JENNIE BRADACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9750 MIRAMAR RD STE 130, SAN DIEGO, CA 92126-4561
(858) 305-0878
Mailing address
6516 CANYON CREST DR, MCKINNEY, TX 75071-4694
(858) 305-0878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9504
CA
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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