Individual
BRADLEY IAN MCMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4062 ARLETA AVE NE, KEIZER, OR 97303-4758
(503) 390-2271
Mailing address
1026 HIDDEN CREEK DR NE, APT. 201, KEIZER, OR 97303-7915
(541) 603-1821
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
08866
OR
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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