Individual
BRIAN BRADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1835 COUNTY ROAD C W STE 150, ROSEVILLE, MN 55113
(763) 581-0340
(763) 581-0341
Mailing address
1835 COUNTY ROAD C W STE 150, ROSEVILLE, MN 55113-1343
(763) 581-0340
(763) 581-0341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
12332
MN
363AM0700X
Medical Physician Assistant
Primary
12332
MN
Other
Enumeration date
01/12/2017
Last updated
07/23/2018
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