Individual
BRADLEY J GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
784 EL PINTADO RD, DANVILLE, CA 94526-1407
(920) 562-6481
Mailing address
784 EL PINTADO RD, DANVILLE, CA 94526-1407
(920) 562-6481
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
47408
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34588100
—
WI
Enumeration date
06/23/2006
Last updated
08/18/2008
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