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BRADY JAMES ABBOTT
>> Organized Health Care Education/Training Program >> StudentRegistrant NPI Number: 1114508660
Individual Registrant: BRADY JAMES ABBOTT
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
3203 CARROLL ULMER RD VALDOSTA, GA 31601-2133 US
Tel: 229-251-0173 Fax: --
Tel: 229-251-0173 Fax: --
Contact information for business:
3203 CARROLL ULMER RD VALDOSTA, GA 31601-2133 US
Tel: 229-251-0173 Fax: --
Tel: 229-251-0173 Fax: --
Registration Information:
NPI: 1114508660
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 390200000X | Student Organized Health Care Education/Training Program | GA | |
| N | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist | GA |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
