Individual
BRIAN BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
1113 N FANT ST, ANDERSON, SC 29621-4819
(864) 225-1683
Mailing address
1113 N FANT ST, ANDERSON, SC 29621-4819
(864) 225-1683
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245288745
—
SC
Enumeration date
07/19/2012
Last updated
07/19/2012
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