Provider Information for 1629636857
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BRADLEY DANIEL JUMP LPC
Sex: Male
NPI: 1629636857
Last Updated: 2024-12-02
Certification Date: 2024-11-20
Certification Date: 2024-11-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1629636857 | ||||||||
| Enumeration Date | 2019-06-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 222 S MAIN ST CAMBRIDGE SPRINGS, PA 16403-1140 United States Phone: 814-573-0993 | Fax: | ||||||||
| Primary Practice Address | 222 S MAIN ST CAMBRIDGE SPRINGS, PA 16403-1140 United States Phone: 814-573-0993 | Fax:833-422-0143 | ||||||||
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