Individual
DR. BRADLEY J TENNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4105 BRIARGATE PKWY STE 125, COLORADO SPRINGS, CO 80920-3482
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0065608
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029158
KAISER COMMERCIAL NUMBER
CO
Enumeration date
03/28/2018
Last updated
07/21/2021
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