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Individual

BRADLEY JAMES BROCKBANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1830 GOOD HOPE RD, ENOLA, PA 17025-1233
(717) 988-8135
(717) 221-5600
Mailing address
1090 PEGGY DR APT 4, HUMMELSTOWN, PA 17036-9026

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1169824
PA
363A00000X
Physician Assistant
Primary
MA062721
PA

Other

Enumeration date
08/03/2021
Last updated
05/08/2024
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