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Individual

MRS. ALICIA BRADEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
6606 LINCOLN ST, BONNERS FERRY, ID 83805-8513
(208) 290-7088
Mailing address
6694 PINE ST., BONNERS FERRY, ID 83805-8513
(208) 267-7869

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA00011216
WA

Other

Enumeration date
03/25/2008
Last updated
03/25/2008
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