Provider Demographics
NPI:1700141306
Name:STROHM, BRADLEY (RN)
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:
Last Name:STROHM
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15875 LONDON RD
Mailing Address - Street 2:
Mailing Address - City:ORIENT
Mailing Address - State:OH
Mailing Address - Zip Code:43146-9728
Mailing Address - Country:US
Mailing Address - Phone:614-716-9695
Mailing Address - Fax:
Practice Address - Street 1:15875 LONDON RD
Practice Address - Street 2:
Practice Address - City:ORIENT
Practice Address - State:OH
Practice Address - Zip Code:43146-9728
Practice Address - Country:US
Practice Address - Phone:614-716-9695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH227772163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse