Individual
BARBARA JEAN BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1200
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3669
AZ
Other
Enumeration date
08/01/2008
Last updated
03/20/2013
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