Individual
TIMOTHY BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14330 E SPRUCE CIRCLE, TALKEETNA, AK 99676-0984
(907) 733-8052
(907) 733-8054
Mailing address
PO BOX 984, TALKEETNA, AK 99676-0984
(907) 733-8052
(907) 733-8054
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
32683
AK
Other
Enumeration date
07/08/2011
Last updated
07/08/2011
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