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Individual

BRADLEY DON RASMUSSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4425 E AGAVE RD, SUITE 148, PHOENIX, AZ 85044-0619
(480) 704-7546
(480) 704-7549
Mailing address
4425 E AGAVE RD, SUITE 148, PHOENIX, AZ 85044-0619
(480) 704-7546
(480) 704-7549

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
27555
AZ
207N00000X
Dermatology Physician
5663814-1205
UT

Other

Enumeration date
07/04/2006
Last updated
11/12/2015
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