Individual
JACOB BRALDEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 DUCALE DR SE, RIO RANCHO, NM 87124-8772
(505) 948-8675
Mailing address
1401 DUCALE DR SE, RIO RANCHO, NM 87124-8772
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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