Individual
BRADLEY TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
610 W GRAND AVE, HOT SPRINGS, AR 71901-3922
(501) 625-7800
(501) 325-2727
Mailing address
2106 REDWOOD, BENTON, AR 72015-2525
(501) 625-7800
(501) 325-2727
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT3770
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204765721
—
AR
Enumeration date
11/04/2014
Last updated
11/04/2014
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