Individual
BRADLEY JAMES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5289 STATE ST, KELSEYVILLE, CA 95451
(707) 279-0881
(707) 279-0887
Mailing address
PO BOX 551, KELSEYVILLE, CA 95451-0551
(707) 279-0881
(707) 279-0887
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT22821
CA
Other
Enumeration date
04/22/2006
Last updated
05/25/2010
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