Individual
BRADLEY DAVID VAN TASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
445 GALTIER ST, SAINT PAUL, MN 55103-2358
(651) 224-1848
Mailing address
15378 FOSTER DR N, HUGO, MN 55038-8544
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9158A
AZ
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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