Doctor Name: | SOPHIA LE BRADLEY |
NPI Number: | 1073952362 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 707 N Alvernon Way Ste 101 Tucson, AZ - 857111830 |
Business Phone Number: | 5206941607 |
Business Fax Number: | 5206941428 |
Mailing Address: | 707 N Alvernon Way Ste 101, TUCSON |
State: | AZ |
Postal Code: | 857111830 |
Phone Number: | 5206941607 |
Fax Number: | 5206941428 |
NPI Enumeration Date: | 06/19/2013 |
NPI Last Update Date: | 05/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |