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Individual

BRADLEY BENICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 262-8309
Mailing address
1522 HANNUM DR, STREETSBORO, OH 44241-5194

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28219614A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
28219614A
INDIANA BOARD OF NURSING
IN
Enumeration date
06/10/2020
Last updated
06/10/2020
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