Individual
BRADLY GRANT MACOUBRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4801 E LINWOOD BLVD, KANSAS CITY, MO 64128-2226
(816) 861-4700
Mailing address
3308 S COCHISE AVE, INDEPENDENCE, MO 64057-1856
(816) 786-5057
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
2010021448
MO
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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