BRADLEY W WINE

ANCHORAGE, AK
NPI1578126561
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: AK  146256)
Enumeration Date2019-04-16
Last Update Date2019-06-21
Business Address
BRADLEY W WINE MD
1201 E 36TH AVE
ANCHORAGE, AK 99508-4372
Phone number: 907-562-9229
Mailing Address
BRADLEY W WINE MD
PO BOX 4105
PORTLAND, OR 97208-4105
Phone number: 866-907-1068