Doctor Name: | WAYNE JOSEPH BRADDOCK |
NPI Number: | 1558507533 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 3867 |
Business Practice Address: | 9428 W. 58th Ave. Arvada, CO - 80002 |
Business Phone Number: | 3034200264 |
Business Fax Number: | 3034200779 |
Mailing Address: | 9428 W. 58th Ave., ARVADA |
State: | CO |
Postal Code: | 80002 |
Phone Number: | 3034200264 |
Fax Number: | 3034200779 |
NPI Enumeration Date: | 12/23/2008 |
NPI Last Update Date: | 04/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 3867 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |