Individual
BRADLEY P BRUNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2408 HILL AVE, MIDDLETOWN, OH 45044-4732
(513) 569-6780
(859) 372-0065
Mailing address
PO BOX 427, FLORENCE, KY 41022-0427
(513) 569-6780
(859) 372-0065
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50001078
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00644116
RR MEDICARE
OH
Enumeration date
05/22/2006
Last updated
08/26/2013
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