Most Relevant Information
Provider Data
| NPI Number: | 1003424516 |
| Provider Name: | BRADLEY RUSSELL HORTON MS, RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/21/2020 |
| Last Updated: | 07/21/2020 |
Provider Practice Location
7681 DOONE VALLEY CT
AVON
IN
461237882
Practice Location Phone/Fax
| Phone: | 3173706650 |
| Fax: |
Provider Mailing Location
7681 DOONE VALLEY CT
AVON
IN
461237882
Provider Mailing Phone/Fax
| Phone: | 3173706650 |
| Fax: |