Individual
DANIEL ADAM BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
505 ROBERT BLVD, SLIDELL, LA 70458-1645
(985) 643-6900
Mailing address
1102 FAIRFIELD CT, MANDEVILLE, LA 70448-1051
(504) 491-5872
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04108
LA
Other
Enumeration date
11/29/2020
Last updated
11/29/2020
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