Individual
BRADLEY ALAN STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11958 W BROAD ST, HENRICO, VA 23233-1007
(804) 360-4669
(804) 364-6521
Mailing address
1115 BOULDERS PKWY, STE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 915-4607
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0102204430
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
559509
TEXAS MEDICAL BOARD
TX
Enumeration date
06/20/2011
Last updated
07/09/2020
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