Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 00-589 | AZ |
NPI | 1144344037 |
---|---|
Provider Name | Dr. Bradley Jay Smith |
First Address | Chandler, AZ 85224-8689 |
Second Address | Tempe, AZ 85282-5403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2007 |
Last Update Date | 08/07/2007 |