Organization
BRAD RICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY DAVID RICE JR. MS CCC-SLP (OWNER/THERAPIST)
(847) 890-5703
Entity
Organization
Contact information
Practice address
22881 N 103RD LN, PEORIA, AZ 85383-2757
(847) 890-5703
(833) 815-2428
Mailing address
22881 N 103RD LN, PEORIA, AZ 85383-2757
(847) 890-5703
(833) 815-2428
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861751653
—
AZ
Enumeration date
11/21/2018
Last updated
11/21/2018
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