Russell E. Bradley III
Individual provider Active NPI Home Modifications Contractor · Lawrenceburg, IN
NPI 1306085303 · NPPES record last updated Feb 13, 2009
Key facts
- NPI
- 1306085303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Modifications Contractor 171WH0202X
- Practice address
- 19803 Ventura Dr
Lawrenceburg, IN 47025-8839 - Phone
- (513) 615-8146
- Fax
- (513) 202-1371
- NPI assigned
- Feb 13, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | Yes |
Addresses
Primary practice location
19803 Ventura Dr
Lawrenceburg, IN 47025-8839
Mailing address
19803 Ventura Dr
Lawrenceburg, IN 47025-8839
Phone (513) 615-8146
Other providers in Lawrenceburg, IN
- John A Botsford
- Bashar Bouso
- Angela Mason Boyd
- Brace Shop & Prosthetic Services Inc
- Ellen Colleen Bradley
- Michael Andrew Bradshaw
- Brian C Oyler Family Dentistry PC
- Bright Dental LLC
- Bright Health & Wellness Center
- Bright Volunteer Fire Company Inc
All providers in Lawrenceburg, IN · Home Modifications Contractor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.