Individual
BRADLEY BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
V538 COUNTY ROAD 4A, LIBERTY CENTER, OH 43532-8512
(419) 966-6384
Mailing address
V538 COUNTY ROAD 4A, LIBERTY CENTER, OH 43532-8512
(419) 966-6384
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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