Individual
BRADLEY JAMES BERTRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC III
Contact information
Practice address
425 W 3RD ST, PUEBLO, CO 81003-3207
(719) 404-1992
Mailing address
425 W 3RD ST, PUEBLO, CO 81003-3207
(719) 404-1992
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6416
CO
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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