Individual
JACOB F BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
444 WASHINGTON ST, SUITE 401, WOBURN, MA 01801-1046
(781) 937-9777
Mailing address
9 LAWRENCE RD, LYNN, MA 01904-2071
(781) 593-3277
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8822
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161216796
TAX ID
MA
Enumeration date
04/03/2009
Last updated
04/03/2009
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