Bradley Farel Hathaway

NPI #1003643412 in Greenville, Mississippi

Provider Information

NPI Number: 1003643412
Entity Type: Individual
Name: Bradley Farel Hathaway
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 18, 2024
Last Updated: Sep 18, 2024

Practice Location

Address: 167 BAYOU RD
City: Greenville
State: Mississippi
ZIP Code: 38701-7732
Phone: (662) 820-3939

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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