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1376837286
BRADLEY JAMES BERTRAND
PUEBLO, CO
NPI
1376837286
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO 6416)
Enumeration Date
2011-06-08
Last Update Date
2011-06-08
Business Address
-- BRADLEY JAMES BERTRAND CAC III
425 W 3RD ST
PUEBLO, CO 81003-3207
Phone number: 719-404-1992
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Mailing Address
-- BRADLEY JAMES BERTRAND CAC III
425 W 3RD ST
PUEBLO, CO 81003-3207
Phone number: 719-404-1992
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