Individual
MR. BRADLEY W. SAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, M.S.ED.
Contact information
Practice address
2737 E BRESSINGHAM WAY, BLOOMINGTON, IN 47401-4168
(814) 746-2696
Mailing address
2737 E BRESSINGHAM WAY, BLOOMINGTON, IN 47401-4168
(814) 746-2696
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002345A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36002345A
ATHLETIC TRAINING LICENSE
IN
Enumeration date
10/31/2011
Last updated
12/05/2014
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