Individual
BRAD VICTOR NUTTALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
18325 N ALLIED WAY STE 100, PHOENIX, AZ 85054-3106
(602) 467-4966
(480) 419-5401
Mailing address
18325 N ALLIED WAY STE 100, PHOENIX, AZ 85054-3106
(602) 467-4966
(480) 419-5401
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2722
AZ
152W00000X
Optometrist
3140
OK
152W00000X
Optometrist
S-D88-TA-A81
AL
Other
Enumeration date
08/14/2017
Last updated
09/04/2024
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