Individual
BRADLEY JAY DECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2978 CENTREVILLE RD, HERNDON, VA 20171-6253
(703) 934-5000
Mailing address
2386B HICKORY NUT LN, HERNDON, VA 20171-2841
(540) 247-9163
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119-008157
VA
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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