Individual
ROGER B BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
223 WINTERSAGE CIR UNIT A, TALENT, OR 97540-9515
(541) 482-3126
(541) 482-0593
Mailing address
223 WINTERSAGE CIR UNIT A, TALENT, OR 97540-9566
(541) 482-3126
(541) 482-0593
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2192
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230041
—
OR
Enumeration date
06/19/2006
Last updated
02/01/2019
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