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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN BRADLEY (OWNER/CEO)
(513) 680-3918
Entity
Organization

Contact information

Practice address
1818 GARDEN LN, CINCINNATI, OH 45237-5722
(513) 680-3918
Mailing address
1818 GARDEN LN, CINCINNATI, OH 45237-5722

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary

Other

Enumeration date
10/11/2016
Last updated
10/11/2016
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