Most Relevant Information
Provider Data
| NPI Number: | 1003231317 |
| Provider Name: | LAUNCE BRADDOCK |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | OTA000794 |
Most Important Dates
| Enumeration Date: | 02/24/2014 |
| Last Updated: | 02/24/2014 |
Provider Practice Location
415 AIRPORT RD
GRIFFIN
GA
302244834
Practice Location Phone/Fax
| Phone: | 7702278636 |
| Fax: |
Provider Mailing Location
415 AIRPORT RD
GRIFFIN
GA
302244834
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |