Individual
BRADLEY JUSTIN BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
34 ORCHARD ST, HOLLEY, NY 14470-1060
(585) 414-8637
Mailing address
34 ORCHARD ST, HOLLEY, NY 14470-1060
(585) 414-8637
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
658252
NY
164W00000X
Licensed Practical Nurse
295277
NY
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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