Individual
JOSHUA BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
6051 W EMERALD ST, BOISE, ID 83704
(208) 302-5150
Mailing address
6975 W. PREECE LANE, APT 102, BOISE, ID 83704
(425) 269-5885
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000051184
ID
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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