Organization
BRADLEY SMITH INNOVATIVE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY J SMITH P.T. (OWNER)
(707) 533-3170
Entity
Organization
Contact information
Practice address
5289 STATE ST., KELSEYVILLE, CA 95451-9449
(707) 533-3170
Mailing address
P.O. BOX 551, KELSEYVILLE, CA 95451-0551
(707) 533-3170
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT22821
CA
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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