Individual
BRAD MCEWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 W PIERCE ST APT 94, CARLSBAD, NM 88220-5246
(903) 724-4949
Mailing address
910 W PIERCE ST APT 94, CARLSBAD, NM 88220-5246
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4986
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4986
PT LICENSE
NM
Enumeration date
12/14/2017
Last updated
12/14/2017
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