Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH12976 | FL |
NPI | 1003450743 |
---|---|
Provider Name | Dr. Bradley Cole Nuber |
First Address | Parkland, FL 33076-1982 |
Second Address | Parkland, FL 33076-1982 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2019 |
Last Update Date | 06/11/2019 |