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Individual

DAVID R BRADSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MED, LP

Contact information

Practice address
14569 GRAND AVE, SUITE 200, BURNSVILLE, MN 55306-5729
(952) 892-7690
(952) 898-4930
Mailing address
14569 GRAND AVE, SUITE 200, BURNSVILLE, MN 55306-5729
(952) 892-7690
(952) 898-4930

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3945
MN

Other

Enumeration date
10/25/2006
Last updated
07/08/2007
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