Individual
BRADLY DALE STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 OAKDALE DR, SOMERSET, KY 42503-9680
(606) 477-0482
Mailing address
112 OAKDALE DR, SOMERSET, KY 42503-9680
(606) 477-0482
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A04021
KY
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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