Individual
MR. BRADFORD L JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
831 BUTTERFIELD RD, WHEATON, IL 60189-8674
(630) 681-1234
Mailing address
6020 OAKWOOD DR, APT.#5A, LISLE, IL 60532-3088
(630) 670-8159
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
160004183
IL
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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