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Individual

BRADLEY JAMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3345 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 528-6225
Mailing address
3345 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 881-1345

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
P-287
ID
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P-287
ID
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/27/2020
Last updated
06/07/2023
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