Individual
JACOB BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3209 COURTYARD DR STE L, MIDLAND, TX 79705-3276
(432) 269-0526
Mailing address
3209 COURTYARD DR STE L, MIDLAND, TX 79705-3276
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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