Individual
BRADLEY OPHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1819 CAREW ST, FORT WAYNE, IN 46805-4705
(805) 570-2260
Mailing address
1819 CAREW ST, FORT WAYNE, IN 46805-4705
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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