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1821579012
JESSE G BRADSHAW
BURLEY, ID
NPI
1821579012
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA1467)
Enumeration Date
2018-08-24
Last Update Date
2018-12-13
Business Address
JESSE G BRADSHAW PA-C
1252 BENNETT AVE STE B
BURLEY, ID 83318-2664
Phone number: 208-647-0656
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Mailing Address
JESSE G BRADSHAW PA-C
243 CHENEY DR W STE 200
TWIN FALLS, ID 83301-4278
Phone number: 208-647-0656
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