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Bradley Provence
Nutrition Support Pharmacist in Millington, Tennessee
NPI 1225442155

Bradley Provence is a Nutrition Support Pharmacist based in Millington, TN and is specialized in Nutrition Support. Bradley Provence practices in Millington, TN. The NPI Number for Bradley Provence is 1225442155 and holds a License No. 7696 (Tennessee).

The current practice location address for Bradley Provence is 7899 C St, Millington, TN and can be reached out via phone at 901-872-2214.

Location: 7899 C St, Millington, TN, 38053-2137
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225442155
Provider Name
Bradley Provence
Credential
Provider Entity Type
Individual
Gender
Male
Address
7899 C St, Millington, TN, 38053-2137
Phone Number
901-872-2214
Fax Number
Provider Enumeration Date
06/18/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
7899 C St
City
Millington
State
Tennessee
Zip
38053-2137
Phone Number
901-872-2214
Fax Number
person
Provider Business Mailing Address Details
Address
7899 C St
City
Millington
State
Tennessee
Zip
38053-2137
Phone Number
901-872-2214
Fax Number
person
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
Nutrition Support
Taxonomy
1835N1003X
License No.
7696 (Tennessee)
Definition
A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs.
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