Individual
MR. DAVID S BRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
119 N. MARKET ST., SHREVE, OH 44676
(330) 567-2823
(330) 567-2660
Mailing address
P.O. BOX 582, 119 N. MARKET ST., SHREVE, OH 44676
(330) 567-2823
(330) 567-2660
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03-2-12838
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665990
—
OH
Enumeration date
11/23/2005
Last updated
07/15/2008
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