Provider Demographics
NPI:1043545171
Name:PAUL BRAADT PC
Entity type:Organization
Organization Name:PAUL BRAADT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRAADT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-776-2005
Mailing Address - Street 1:1028 S CEDAR CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5444
Mailing Address - Country:US
Mailing Address - Phone:610-776-2005
Mailing Address - Fax:610-776-1475
Practice Address - Street 1:1028 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-5444
Practice Address - Country:US
Practice Address - Phone:610-776-2005
Practice Address - Fax:610-776-1475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty