Individual
BRADLEY DOUGLAS HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1402 S GRAND BLVD # M260, SAINT LOUIS, MO 63104-1004
(314) 268-7274
Mailing address
866 GRANADA LN, VACAVILLE, CA 95688-2058
(707) 235-5620
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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