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Organization

BRADLEY EYECARE, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASON L BRADLEY O.D. (OPTOMETRIST/DIRECTOR)
(701) 852-5626
Entity
Organization

Contact information

Practice address
207 MAIN ST S, MINOT, ND 58701-3915
(701) 852-5626
Mailing address
207 MAIN ST S, MINOT, ND 58701-3915
(701) 852-5626

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
544
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01475002
BLUE CROSS BLUE SHIELD
ND
01
01475003
VISION SERVICES, INC
ND
05
60632
ND
Enumeration date
10/10/2006
Last updated
06/21/2018
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