Bradley Provence
Nutrition Support
7899 C St, Millington
Tennessee, 38053-2137
901-872-2214 Bradley Provence is a pharmacist who is specialized in Nutrition Support in Millington, Tennessee. Patients can reach him at 7899 C St, Millington or contact him on 901-872-2214. Active license number of Bradley Provence is 7696 for Nutrition Support in Tennessee.
Bradley Provence is a licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs.
Complete Profile:
Bradley Provence speciality, credentials, practice address, contact phone number and fax are as below. Patients can call on the below given phone number for enquiries.
| Name: | Bradley Provence |
| Specialization: | Nutrition Support |
| Gender: | Male |
| Location: | 7899 C St, Millington,
Tennessee, 38053-2137 |
| Phone: | 901-872-2214 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of Bradley Provence are as mentioned below.
| NPI Number: | 1225442155 |
| NPI Enumeration Date: | 18 Jun, 2014 |
| NPI Last Update On: | 18 Jun, 2014 |
Medical Licenses:
Pharmacists can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Bradley Provence are as mentioned below.
| Specialization | License Number | State | Status | |
| Nutrition Support | 7696 | Tennessee | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 7899 C St,
Millington, Tennessee |
| Zip: | 38053-2137 |
| Phone Number: | 901-872-2214 |
Patients can reach Bradley Provence at
7899 C St, Millington, Tennessee or can
call on phone at 901-872-2214.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.