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NPI 1063985513

NPI 1063985513 : BFB WELLNESS, LLC : HUDSON, OH

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General NPI Number Information
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    NPI Number           |    1063985513
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    Entity Type          |    Organization 
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    Legal Business Name  |    BFB WELLNESS, LLC 
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Dates
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    Enumeration Date     |    01/08/2019
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    Last Update Date     |    01/08/2019
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Provider Practice Location Address
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    Address Line         |    1340 CORPORATE DR STE 300 
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    City                 |    HUDSON
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    State                |    OH
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    Zip                  |    44236-4444
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    Country              |    US
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    Telephone            |    234-284-8002
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    Fax                  |    234-284-8002
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Provider Business Mailing Address
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    Address Line         |    1340 CORPORATE DR STE 300 
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    City                 |    HUDSON
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    State                |    OH
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    Zip                  |    44236-4444
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CHIROPRACTIC PHYSICIAN/ OWNER
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    Name                 |    DR. ANDREW THOMAS BRADY 
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    Credential           |    D.C
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    Telephone            |    234-284-8002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    
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    License Number State |    
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