Individual
NICOLAS BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1301 W PARKS HWY STE 101, WASILLA, AK 99654-6939
(073) 577-7819
(907) 745-6573
Mailing address
1301 W PARKS HWY STE 101, WASILLA, AK 99654-6939
(073) 577-7819
(907) 745-6573
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PADA1173
AK
Other
Enumeration date
02/18/2010
Last updated
05/11/2022
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