Provence, Bradley

Provence, Bradley is an sole proprietor health care provider with primary practice located at 7899 C St , Millington TN 38053-2137. He recently has only one registered license in Pharmacy Service Providers / Nutrition Support, which is considered as his primary health care specialty. Provence, Bradley can be contacted via phone (901) 872-2214.

Contact Information

Primary practice address
7899 C St Millington TN 38053-2137
Phone: (901) 872-2214
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Nutrition Support 1835N1003X 7696 Tennessee

Profile Details

NPI number 1225442155
LBN Legal business name Provence, Bradley
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2014
Last updated Jun 18th, 2014 - about 10 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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