Provider Demographics
NPI:1952347320
Name:BRAFFORD, PHILIP EDWARD JR (DC)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:EDWARD
Last Name:BRAFFORD
Suffix:JR
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 1:1742 W CHEROKEE STREET
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29702
Mailing Address - Country:US
Mailing Address - Phone:864-839-2776
Mailing Address - Fax:864-839-2776
Practice Address - Street 1:1742 W CHEROKEE STREET
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:SC
Practice Address - Zip Code:29702
Practice Address - Country:US
Practice Address - Phone:864-839-2776
Practice Address - Fax:864-839-2776
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2277111N00000X
NC3095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor