MEDICARE: CLAIRE OLIVIA BRADBURY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1609604024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE OLIVIA BRADBURY

Provider Business Mailing Address
First Line	:	44 W STATE ST APT A
Second Line	:
City	:	ATHENS
State	:	OH
Zip	:	45701-2515
Country	:	US
Telephone Number	:	740-444-9261
Fax Number	:

Provider Business Practice Location Address
First Line	:	44 W STATE ST APT A
Second Line	:
City	:	ATHENS
State	:	OH
Zip	:	45701-2515
Country	:	US
Telephone Number	:	740-444-9261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	07/25/2024

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Directions to “ CLAIRE OLIVIA BRADBURY ” Practice Location

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