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BRADLEY JAMES SMITH PT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1407812019

Individual Registrant:
 BRADLEY JAMES SMITH PT
Gender: M
Sole Proprietor

Location and contact information for practice:
5289 STATE ST  KELSEYVILLE, CA 95451 US
Tel: 707-279-0881  Fax: 707-279-0887

Contact information for business:
PO BOX 551  KELSEYVILLE, CA 95451-0551 US
Tel: 707-279-0881  Fax: 707-279-0887

Registration Information:
NPI: 1407812019
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CAPT22821

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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