Provider Demographics
NPI:1003518267
Name:BRONSON, RICK A
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:A
Last Name:BRONSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 ERIE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-4021
Mailing Address - Country:US
Mailing Address - Phone:614-663-7241
Mailing Address - Fax:
Practice Address - Street 1:8871 CRESTRIDGE CT
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-9472
Practice Address - Country:US
Practice Address - Phone:614-535-8752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health