Healthcare Provider Details

I. General information

NPI: 1831006956
Provider Name (Legal Business Name): BRADEN ATTEBURY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3232 INDEPENDENCE ST
CAPE GIRARDEAU MO
63701-4904
US

IV. Provider business mailing address

5828 FEATHER TRAIL RD
ULLIN IL
62992-2125
US

V. Phone/Fax

Practice location:
  • Phone: 573-335-7349
  • Fax:
Mailing address:
  • Phone: 618-841-6885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2026041130
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: