Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 30022655 | OH |
NPI | 1073779575 |
---|---|
Provider Name | Dr. Bradley A Purcell |
First Address | Worthington, OH 43085-2515 |
Second Address | Worthington, OH 43085-2515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 25/10/2012 |