Individual
BRAD DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2960 BLACKHAWK DR, WILLITS, CA 95490-8770
(707) 367-1456
Mailing address
2960 BLACKHAWK DR, WILLITS, CA 95490-8770
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN733632
CA
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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