Provider Demographics
NPI:1629300645
Name:COX, BRADLEY THOMAS
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:THOMAS
Last Name:COX
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 1:53 BROMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2142
Mailing Address - Country:US
Mailing Address - Phone:908-403-3951
Mailing Address - Fax:
Practice Address - Street 1:53 BROMFIELD ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2142
Practice Address - Country:US
Practice Address - Phone:908-403-3951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist