Individual
MR. BRADLEY D MORIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PT
Contact information
Practice address
7300 SECOR RD, LAMBERTVILLE, MI 48144-9376
(734) 854-1260
(734) 854-3581
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010355
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01391767
RR MEDICARE
MI
Enumeration date
07/31/2006
Last updated
01/22/2015
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