Individual
BRADLEY MICHAEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.P.
Contact information
Practice address
6209 TRAIL LAKE DR, FORT WORTH, TX 76133-3405
(817) 793-3773
Mailing address
6209 TRAIL LAKE DR, FORT WORTH, TX 76133-3405
(817) 793-3773
Taxonomy
Speciality
Code
Description
License number
State
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
Primary
ATP13910
TX
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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