Individual provider · Type 1 NPI
Bradley Provence
Nutrition Support Pharmacist · Millington, TN
NPI number
1225442155
Active
Practice location
7899 C St
Millington, TN 38053-2137
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nutrition Support Pharmacist Primary | 1835N1003X | 7696 (TN) |
Nutrition Support Pharmacist: A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs.
4 other providers at this address
About NPI 1225442155
Bradley Provence's National Provider Identifier is 1225442155, issued on Jun 18, 2014. The primary taxonomy on file is Nutrition Support Pharmacist (1835N1003X), and the practice location is in Millington, TN. The record was last updated on Jun 18, 2014.