Collin Bradley Chase
Student in an Organized Health Care Education/Training Program in Tampa, FL. Individual provider (NPI-1).
NPI number1497436554
StatusActive
Last updated in NPPESJul 31, 2023
Details
- NPI
- 1497436554
- Entity type
- Individual (NPI-1)
- Name
- Collin Bradley Chase
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2023
- Certification date
- Jul 31, 2023
- Last updated
- Jul 31, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
12901 Bruce B Downs BlvdTampa, FL 33612-4742
Phone 813-396-9459
Mailing address
12901 Bruce B Downs BlvdTampa, FL 33612-4742
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