Provider Demographics
NPI:1861689333
Name:HALLING, BRADLEY JAMES (CP #02989)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:JAMES
Last Name:HALLING
Suffix:
Gender:M
Credentials:CP #02989
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Mailing Address - Street 1:304 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-8192
Mailing Address - Country:US
Mailing Address - Phone:910-638-5900
Mailing Address - Fax:910-245-2235
Practice Address - Street 1:304 EDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-8192
Practice Address - Country:US
Practice Address - Phone:910-638-5900
Practice Address - Fax:910-245-2235
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist