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1184950016
BRADLEY DALE PEARSON
IDAHO FALLS, ID
NPI
1184950016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: ID PT-1125)
Enumeration Date
2009-10-28
Last Update Date
2009-10-28
Business Address
-- BRADLEY DALE PEARSON MPT
720 S WOODRUFF AVE
IDAHO FALLS, ID 83401-5285
Phone number: 208-552-5025
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Mailing Address
-- BRADLEY DALE PEARSON MPT
720 S WOODRUFF AVE
IDAHO FALLS, ID 83401-5285
Phone number: 208-552-5025
Copy
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