Individual
MR. EDWARD BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6650 VIRGILIAN ST, NEW ORLEANS, LA 70126-2648
(504) 270-4619
Mailing address
6650 VIRGILIAN ST, NEW ORLEANS, LA 70126-2648
(504) 270-4619
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
008810870
LA
347C00000X
Private Vehicle
Primary
008810870
LA
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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