Organization
R RALPH BRADLEY M D PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH BRADLEY M.D. (OWNER)
(801) 268-9672
Entity
Organization
Contact information
Practice address
166 E 5900 S, B-111, MURRAY, UT 84107-7257
(801) 268-9672
(801) 266-9390
Mailing address
166 E 5900 S, B-111, MURRAY, UT 84107-7257
(801) 268-9672
(801) 266-9390
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
162090-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529622566001
—
UT
Enumeration date
01/20/2009
Last updated
02/12/2009
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