Individual
BRADLEY JAMES GICZKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
275 E HUNTSVILLE RD, FAYETTEVILLE, AR 72701-6134
(479) 935-7050
Mailing address
625 N STORER AVE, FAYETTEVILLE, AR 72701-3200
(479) 935-7050
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8181
AR
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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