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Individual

MR. BRADLEY DECKARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1120 FALCON DR, KENNETT, MO 63857-3825
(573) 888-1150
Mailing address
PO BOX 57, SAINT FRANCIS, AR 72464-0057
(870) 598-2277

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2004030992
MO

Other

Enumeration date
07/20/2012
Last updated
07/20/2012
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