Individual
BRADEN ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
197 PIEDMONT BLVD STE 100, ROCK HILL, SC 29732-1825
(803) 324-1950
(803) 324-1933
Mailing address
PO BOX 22224, BELFAST, ME 04915-4473
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5048
SC
363A00000X
Physician Assistant
Primary
5048
SC
Other
Enumeration date
10/03/2023
Last updated
01/30/2025
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