BRADLEY JAMES RUSOVICK

PUEBLO, CO
NPI1548703937
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO  ACC0006272)
Enumeration Date2016-12-02
Last Update Date2016-12-02
Business Address
-- BRADLEY JAMES RUSOVICK
56 DUKE ST 200 WEST "B" STREET, SUITE 226
PUEBLO, CO 81005-1604
Phone number: 719-334-1010
Mailing Address
-- BRADLEY JAMES RUSOVICK
5380 PEREGRINE DR
PUEBLO, CO 81005-5521
Phone number: 719-334-1010
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