Individual
DR. JASON L BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
207 MAIN ST S, MINOT, ND 58701-3915
(701) 852-5626
Mailing address
207 MAIN ST S, MINOT, ND 58701-3915
(701) 852-5626
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
544
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21332
BLUE CROSS BLUE SHIELD
ND
05
—
60504
—
ND
01
—
870544
VISION SERVICES, INC.
ND
Enumeration date
10/10/2006
Last updated
09/21/2016
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