Individual
MR. JOSHUA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
528 HIGHWAY 180 W, SILVER CITY, NM 88061-4400
(575) 534-1747
(575) 534-1748
Mailing address
528 HIGHWAY 180 W, SILVER CITY, NM 88061-4400
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050502025
NATABOC
—
Enumeration date
06/27/2006
Last updated
10/31/2015
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