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1386077196
BRADLEY WALTERS
ALBUQUERQUE, NM
NPI
1386077196
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NM PA2013-0052)
Enumeration Date
2013-08-15
Last Update Date
2021-03-26
Business Address
BRADLEY WALTERS PAC
11501 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87111-2796
Phone number: 505-814-1333
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Mailing Address
BRADLEY WALTERS PAC
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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