Most Relevant Information
Provider Data
| NPI Number: | 1003482779 |
| Provider Name: | BRADEN LOTT DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT-7269 |
Most Important Dates
| Enumeration Date: | 06/02/2021 |
| Last Updated: | 06/02/2021 |
Provider Practice Location
711 RIGBY LAKE DR STE 1301
RIGBY
ID
834425373
Practice Location Phone/Fax
| Phone: | 2082280311 |
| Fax: |
Provider Mailing Location
711 RIGBY LAKE DR STE 1301
RIGBY
ID
834425373
Provider Mailing Phone/Fax
| Phone: | 2082280311 |
| Fax: |