Bertram Pride, | |
1640 Redstone Center Dr, Park City, UT 84098-7605 | |
(214) 264-9711 | |
Not Available |
Full Name | Bertram Pride |
---|---|
Gender | Male |
Speciality | Licensed Practical Nurse |
Location | 1640 Redstone Center Dr, Park City, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1518593110 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
164W00000X | Licensed Practical Nurse | 4703111838 (Michigan) | Primary |
Mailing Address | Practice Location Address |
---|---|
Bertram Pride, 8931 Pardee Rd, Taylor, MI 48180-2741 Ph: () - | Bertram Pride, 1640 Redstone Center Dr, Park City, UT 84098-7605 Ph: (214) 264-9711 |
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