Individual
TIMOTHY BRADBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1548 DORSET DR, AVON, IN 46123-5321
(317) 480-0421
Mailing address
1548 DORSET DR, AVON, IN 46123-5321
(317) 480-0421
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27042942A
IN
Other
Enumeration date
04/22/2025
Last updated
04/23/2025
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