Individual provider · NPI-1

Bradley Barber

Student in an Organized Health Care Education/Training Program · Scottsdale, AZ

NPI number1194299875
StatusActive
Last updated in NPPESJan 16, 2019

Details

NPI
1194299875
Entity type
Individual (NPI-1)
Name
Bradley Barber
Sex
Male
Sole proprietor
No
Enumeration date
Jan 16, 2019
Last updated
Jan 16, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes
2255A2300X Specialist/Technologist, Athletic Trainer––

Practice location

7521 E Mcknight Ave
Scottsdale, AZ 85251-4524

Phone 480-414-0582

Mailing address

7521 E Mcknight Ave
Scottsdale, AZ 85251-4524

Phone 480-414-0582

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