Individual
BRADLEY W. CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
15189 MONTANUS DR, CULPEPER, VA 22701-1679
(540) 825-8220
(866) 691-2912
Mailing address
15189 MONTANUS DR, CULPEPER, VA 22701-1679
(540) 825-8220
(866) 691-2912
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000722
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410036701
—
VA
Enumeration date
12/29/2005
Last updated
02/12/2011
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