Organization
BRADLEY MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY JAMES DAIGREPONT (OWNER)
(318) 253-4952
Entity
Organization
Contact information
Practice address
159 GUILBEAU RD, MANSURA, LA 71350-4408
(318) 253-4952
(318) 253-4952
Mailing address
159 GUILBEAU RD, MANSURA, LA 71350-4408
(318) 253-4952
(318) 253-4952
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/20/2007
Last updated
01/17/2008
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