Bradley Provence
Bradley Provence is a Nutrition Support Pharmacist in Millington, Tennessee. Practices as a sole proprietor. Licensed in Tennessee.
- Licensed in
- TN
- In the registry since
- 2014
Practice location Address checks out
7899 C StMillington, TN 38053-2137
Phone: (901) 872-2214
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nutrition Support Pharmacist (primary) | Taxonomy 1835N1003X · Licence 7696 (TN) |
|---|
Record details
| NPI number | 1225442155 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 18, 2014 |
| Last updated in NPPES | June 18, 2014 |
| Mailing address | 7899 C St, Millington, TN 38053-2137 |