Bradley Ellithorpe
Student in an Organized Health Care Education/Training Program in Fiskdale, MA. Individual provider (NPI-1).
NPI number1134030596
StatusActive
Last updated in NPPESSep 15, 2026
Details
- NPI
- 1134030596
- Entity type
- Individual (NPI-1)
- Name
- Bradley Ellithorpe
- Sole proprietor
- Yes
- Enumeration date
- Sep 15, 2026
- Certification date
- Sep 15, 2026
- Last updated
- Sep 15, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
9 Draper Woods RdFiskdale, MA 01518-1180
Phone 774-601-0382
Mailing address
9 Draper Woods RdFiskdale, MA 01518-1180
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