Individual
BRADLEY STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
108A W OHIO AVE, FOUNTAIN, CO 80817-2240
(352) 601-0155
Mailing address
9418 ELMHURST DR, FOUNTAIN, CO 80817-3165
(352) 601-0155
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT0024977
CO
Other
Enumeration date
08/08/2023
Last updated
11/06/2023
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