Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1039 | NE |
NPI | 1063790582 |
---|---|
Provider Name | Barbara Nell Bradley |
First Address | Omaha, NE 68137-2055 |
Second Address | Omaha, NE 68137-3204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2011 |
Last Update Date | 01/08/2011 |