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Individual

BRADLEY JAMES SIDENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T., CERT. MDT

Contact information

Practice address
15 MCCABE DR STE 101, RENO, NV 89511-4815
(775) 788-5599
(775) 788-5598
Mailing address
15 MCCABE DR STE 101, RENO, NV 89511-4815
(775) 788-5599
(775) 788-5598

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0462
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6500181191
RAILROAD MEDICARE
NV
Enumeration date
10/17/2006
Last updated
10/16/2007
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