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Individual

BRIAN M. BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
401 W PENNSYLVANIA AVE, ANACONDA, MT 59711
(406) 563-8528
(406) 556-3086
Mailing address
401 W PENNSYLVANIA AVE, ANACONDA, MT 59711-1999
(406) 563-8528
(406) 556-3086

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
27323
MT
367500000X
Certified Registered Nurse Anesthetist
Primary
RN27323
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881610616
MT
Enumeration date
07/14/2006
Last updated
02/06/2019
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