Provider Demographics
NPI:1366273294
Name:BRADBURN FAMILY ENTERPRISES
Entity type:Organization
Organization Name:BRADBURN FAMILY ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-778-7447
Mailing Address - Street 1:24 N UNCOMPAHGRE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3958
Mailing Address - Country:US
Mailing Address - Phone:970-778-7447
Mailing Address - Fax:
Practice Address - Street 1:24 N UNCOMPAHGRE AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3958
Practice Address - Country:US
Practice Address - Phone:970-778-7447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty