Individual
BRADLEY P NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1954 FORT UNION BLVD, SALT LAKE CITY, UT 84121-6800
(801) 993-9530
(801) 733-5618
Mailing address
1954 FORT UNION BLVD, SALT LAKE CITY, UT 84121-6800
(801) 993-9530
(801) 733-5618
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2373399-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D0558
—
UT
Enumeration date
07/13/2005
Last updated
07/11/2007
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