Provider Demographics
NPI:1205927670
Name:NORVELL, BRADLEY KENT (BS, ACA)
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:KENT
Last Name:NORVELL
Suffix:
Gender:M
Credentials:BS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 REGANS WAY
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1392
Mailing Address - Country:US
Mailing Address - Phone:740-453-9136
Mailing Address - Fax:
Practice Address - Street 1:735 PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1877
Practice Address - Country:US
Practice Address - Phone:740-453-1103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1224237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist