Individual
MR. BEAU JAMES BRADBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9528
(575) 523-1108
Mailing address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9528
(575) 523-1108
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3083
NM
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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