Individual
DR. MITCHELL BRADDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1170 ALPHARETTA ST, ROSWELL, GA 30075-3631
(770) 998-7774
(770) 998-8814
Mailing address
1170 ALPHARETTA ST, ROSWELL, GA 30075-3631
(770) 998-7774
(770) 998-8814
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR004968
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
543858
BLUE CROSS BLUE SHIELD
GA
Enumeration date
12/18/2006
Last updated
07/08/2007
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