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Individual

DUSTIN TODD BRADLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
808 W 300 N, VERNAL, UT 84078-3812
(435) 828-2541
Mailing address
808 W 300 N, VERNAL, UT 84078-3812
(435) 828-2541

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7562535-4406
UT

Other

Enumeration date
07/17/2015
Last updated
07/17/2015
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