Individual
BRADLEY LIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
797 WILSON ST, BREWER, ME 04412-1000
(207) 992-4042
(207) 992-4043
Mailing address
797 WILSON ST, BREWER, ME 04412-1000
(207) 992-4042
(207) 992-4043
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT4035
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT4035
PHYSICAL THERAPY LICENCE
ME
Enumeration date
08/22/2013
Last updated
08/22/2013
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