Healthcare Provider Details

I. General information

NPI: 1063985513
Provider Name (Legal Business Name): BFB WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 CORPORATE DR STE 300
HUDSON OH
44236-4444
US

IV. Provider business mailing address

1340 CORPORATE DR STE 300
HUDSON OH
44236-4444
US

V. Phone/Fax

Practice location:
  • Phone: 234-284-8002
  • Fax: 234-284-8002
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW THOMAS BRADY
Title or Position: CHIROPRACTIC PHYSICIAN/ OWNER
Credential: D.C
Phone: 234-284-8002