Provider Demographics
NPI:1184325912
Name:TURNAGE, BRAXTON (DC)
Entity type:Individual
Prefix:DR
First Name:BRAXTON
Middle Name:
Last Name:TURNAGE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 OLD JOLLY BAY RD UNIT B101
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32439-4275
Mailing Address - Country:US
Mailing Address - Phone:508-880-6046
Mailing Address - Fax:
Practice Address - Street 1:1255 OLD JOLLY BAY RD UNIT B101
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:FL
Practice Address - Zip Code:32439-4275
Practice Address - Country:US
Practice Address - Phone:508-880-6046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14134111N00000X
LA1961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty