Individual
LARRY ALLAN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2800 10TH AVE N, BILLINGS, MT 59101-0703
(406) 238-2500
Mailing address
22 RIDGE RD, ROUNDUP, MT 59072-6851
(406) 690-5157
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MED-PAC-LIC-59882
MT
363AM0700X
Medical Physician Assistant
Primary
MED-PAC-LIC-59882
MT
Other
Enumeration date
10/11/2017
Last updated
12/14/2021
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