Individual
MR. BRIAN WILLIAM BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1050 OLD DES PERES RD, SUITE 40, SAINT LOUIS, MO 63131-1873
(314) 821-0200
Mailing address
1050 OLD DES PERES RD, SUITE 40, SAINT LOUIS, MO 63131-1873
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005009350
MO
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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