Individual
MR. TYSON BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
Mailing address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004936
IL
Other
Enumeration date
02/05/2010
Last updated
02/05/2010
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