Individual
BRADLEY RADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
2001 S WOODRUFF AVE STE 15B, IDAHO FALLS, ID 83404-6372
(208) 357-4633
Mailing address
2001 S WOODRUFF AVE STE 15B, IDAHO FALLS, ID 83404-6372
(208) 357-4633
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
66122
ID
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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