Individual
BRADLEY GRGURICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Mailing address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040.0134367
VT
225100000X
Physical Therapist
048542
NY
225100000X
Physical Therapist
10798
SC
225100000X
Physical Therapist
11-06940
KS
225100000X
Physical Therapist
11080
CO
225100000X
Physical Therapist
13331
CT
225100000X
Physical Therapist
301264
CA
225100000X
Physical Therapist
P20917
NC
225100000X
Physical Therapist
Primary
PT029354
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11080
LICENSE
CO
Enumeration date
05/01/2012
Last updated
03/15/2022
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