Healthcare Provider Details

I. General information

NPI: 1740134642
Provider Name (Legal Business Name): BRYCE DUBOSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 STOUGH ST
RED LEVEL AL
36474-2116
US

IV. Provider business mailing address

6320 STOUGH ST
RED LEVEL AL
36474-2116
US

V. Phone/Fax

Practice location:
  • Phone: 334-343-7138
  • Fax:
Mailing address:
  • Phone: 334-343-7138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: