Individual
BRIAN BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1400 BLACKHORSE HILL RD, COATESVILLE, PA 19320-2040
(610) 384-7711
Mailing address
1512 VALLEY DR, WEST CHESTER, PA 19382-6360
(484) 883-8079
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN294479
PA
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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