Individual
BRADLEY PATITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
451 S PARK RIDGE RD STE 102, BLOOMINGTON, IN 47401-8589
(812) 822-0189
Mailing address
5556 N MERIDIAN ST, INDIANAPOLIS, IN 46208-2658
(317) 334-7331
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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