Individual
MR. BRADLEY EARL REGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
700 ASH ST, SUSANVILLE, CA 96130-3716
(530) 310-0222
Mailing address
PO BOX 711, SUSANVILLE, CA 96130-0711
(530) 310-0222
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
352328
CA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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