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1295174712
BRADLEY BERGDOLL
CLINTON, AR
NPI
1295174712
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2013-06-18
Last Update Date
2013-06-18
Business Address
-- BRADLEY BERGDOLL Recovery Assistant
242 SHAKE RAG RD
CLINTON, AR 72031-6629
Phone number: 501-745-6644
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Mailing Address
-- BRADLEY BERGDOLL Recovery Assistant
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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