Individual
BRADLEY R REGISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
298 W MARIPOSA RD STE 1, NOGALES, AZ 85621-1089
(520) 394-7388
Mailing address
298 W MARIPOSA RD STE 1, NOGALES, AZ 85621-1089
(520) 394-7388
(510) 879-9100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA16641
CA
Other
Enumeration date
08/23/2006
Last updated
02/24/2021
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