Individual
BRADLEY WAYNE AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9302 N MERIDIAN ST STE 190, INDIANAPOLIS, IN 46260-1818
(317) 843-1270
(317) 843-4174
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010372A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100239270
—
IN
01
—
P01402683
RR MEDICARE
IN
Enumeration date
07/20/2010
Last updated
08/14/2016
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