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General NPI Number Information
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NPI Number | 1891820643
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Entity Type | Individual
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Provider Name | MICHAEL T BRADEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 517 HOLLYWOOD AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08753-6757
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Country | US
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Telephone | 732-341-4900
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Fax | 732-960-5044
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Provider Business Mailing Address
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Address Line | 517 HOLLYWOOD AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08753-6757
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Country | US
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Telephone | 732-341-4900
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Fax | 732-960-5044
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00591700
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License Number State | NJ
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