Provider Demographics
NPI:1679446728
Name:PALEN, BRAD ALLEN
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:ALLEN
Last Name:PALEN
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 1:52885 KEY BELLAIRE RD
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:OH
Mailing Address - Zip Code:43906-9421
Mailing Address - Country:US
Mailing Address - Phone:740-312-5073
Mailing Address - Fax:
Practice Address - Street 1:52885 KEY BELLAIRE RD
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-9421
Practice Address - Country:US
Practice Address - Phone:740-312-5073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant