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General NPI Number Information
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NPI Number | 1982116802
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Entity Type | Individual
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Provider Name | BRADLEY D. STILES L. AC.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 6257 DEEP RIVER CYN
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City | COLUMBIA
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State | MD
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Zip | 21045
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Country | US
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Telephone | 618-402-1038
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Fax |
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Provider Business Mailing Address
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Address Line | 6257 DEEP RIVER CYN
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City | COLUMBIA
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State | MD
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Zip | 21045-2572
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Country | US
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Telephone | 618-402-1038
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U02368
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License Number State | MD
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