Jaclyn Bradley
Technician, Other in Roscommon, MI. Individual provider (NPI-1).
NPI number1982153763
StatusActive
Last updated in NPPESSep 22, 2016
Details
- NPI
- 1982153763
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jaclyn Bradley
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 22, 2016
- Last updated
- Sep 22, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
1599 W Doyle TrlRoscommon, MI 48653-9211
Phone 989-302-7474
Mailing address
1599 W Doyle TrlRoscommon, MI 48653-9211
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