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General NPI Number Information
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NPI Number | 1144344037
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Entity Type | Individual
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Provider Name | BRADLEY JAY SMITH NMD
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Gender | Male
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Dates
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Enumeration Date | 03/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1050 E SOUTHERN AVE SUITE 4
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City | TEMPE
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State | AZ
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Zip | 85282-5403
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Country | US
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Telephone | 480-829-7829
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Fax |
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Provider Business Mailing Address
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Address Line | 1243 W ORCHID LN
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City | CHANDLER
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State | AZ
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Zip | 85224-8689
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Country | US
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Telephone | 480-786-3558
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Fax | 480-814-1389
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 00-589
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License Number State | AZ
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