Individual
BRADLEY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21041 CUPPS CHAPEL RD, METAMORA, IN 47030-9767
(812) 363-5897
Mailing address
21041 CUPPS CHAPEL RD, METAMORA, IN 47030-9767
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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