Individual
BRADLEY COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1995 E 17TH ST STE 2, IDAHO FALLS, ID 83404-6493
(208) 419-2541
Mailing address
3046 JACKIE CT, IDAHO FALLS, ID 83402-5568
(208) 419-2541
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1670A
ID
Other
Enumeration date
01/08/2016
Last updated
01/19/2016
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