Individual
BRADFORD R. PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PT
Contact information
Practice address
1188 UNIVERSITY DR, BOISE, ID 83706
(208) 336-8250
(208) 345-9514
Mailing address
1188 W UNIVERSITY DR, BOISE, ID 83706-3009
(208) 336-8250
(208) 345-9514
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT664
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639175276
—
ID
Enumeration date
06/27/2005
Last updated
08/16/2018
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