NPI 1013746833 · live from the CMS NPI Registry
William Logan Bradley, MS, RDN, LD
Dietitian, Registered in Columbia, MO. National Provider Identifier 1013746833, active.
NPI record
| NPI | 1013746833 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1600 E Broadway, Columbia, MO 65201 |
| Practice phone | 573-815-3189 |
| Enumerated | July 30, 2024 |
| Last updated | July 30, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 2024028310 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.