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Individual
BRADLEY HENRIKSEN
Active
Individual
BRADLEY HENRIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD193060
OR
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
11598920-1205
UT
Other
Enumeration date
08/05/2015
Last updated
07/14/2020
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