Individual
BRADLEY ALAN DAMRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
6700 W 24TH AVE, GARY, IN 46406-2424
(219) 455-1769
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002268A
IN
Other
Enumeration date
01/12/2013
Last updated
01/12/2013
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