Individual
DOUG L BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
380 SUWANNEE TRAIL STREET, BOWLING GREEN, KY 42103
(270) 901-5000
(270) 842-5268
Mailing address
370 THOMPSON HEIGHTS DR, BOWLING GREEN, KY 42101-6318
(270) 901-5000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0037
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
02/12/2007
Last updated
04/04/2008
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