Individual
DERRICK ADRIAN BRADDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2725 E SKELLY DR, TULSA, OK 74105-6241
(918) 407-8847
Mailing address
8086 S YALE AVE, #236, TULSA, OK 74136-9003
(918) 407-6426
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/10/2008
Last updated
08/10/2008
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