Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Public Health or Welfare |
251K00000X | 60 | Public Health or Welfare Agency |
| NPI Number | 1851410062 |
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| LBN Legal business name | BRAD JONES PROGRESSIVE PEDIATRICS PC | ||||||||
| Authorized official | BRAD JONES - (PRESIDENT) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 03/28/2007 | ||||||||
| Last updated | 01/10/2012 - About 14 years ago | ||||||||
| Identifiers |
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