Crockett, Bradley Dwayne
Crockett, Bradley Dwayne is an sole proprietor health care provider with primary practice located at 240 West 940 North , Provo UT 84604. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Crockett, Bradley Dwayne can be contacted via phone (801) 374-4800.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 103TS0200X |
Profile Details
| NPI number | 1134867310 |
|---|---|
| LBN Legal business name | Crockett, Bradley Dwayne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 26th, 2022 |
| Last updated | May 26th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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