Most Relevant Information
Provider Data
| NPI Number: | 1003304973 |
| Provider Name: | BRADEN MONTGOMERY TARR |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/26/2018 |
| Last Updated: | 04/26/2018 |
Provider Practice Location
303 OFFNERE ST
PORTSMOUTH
OH
456624655
Practice Location Phone/Fax
| Phone: | 7408769369 |
| Fax: |
Provider Mailing Location
902 GALLIA ST
PORTSMOUTH
OH
456624139
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |