Provider Demographics
NPI:1982364642
Name:EATON, BRADFORD CHARLES (NBC-HWC)
Entity Type:Individual
Prefix:MR
First Name:BRADFORD
Middle Name:CHARLES
Last Name:EATON
Suffix:
Gender:M
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-0411
Mailing Address - Country:US
Mailing Address - Phone:860-395-7514
Mailing Address - Fax:
Practice Address - Street 1:214 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-5512
Practice Address - Country:US
Practice Address - Phone:860-577-2407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date: