Individual
MR. BRADLEY L WALKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 S RAILROAD AVE, POCATELLO, ID 83204-3205
(208) 236-5215
(208) 236-5201
Mailing address
5033 REDFISH ST, CHUBBUCK, ID 83202-3031
(208) 237-8376
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-85A
ID
Other
Enumeration date
01/23/2006
Last updated
07/08/2007
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