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1871563007
BRADLEY L WALKER
POCATELLO, ID
NPI
1871563007
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: ID NP-85A)
Enumeration Date
2006-01-23
Last Update Date
2007-07-08
Business Address
Mr. BRADLEY L WALKER
120 S RAILROAD AVE
POCATELLO, ID 83204-3205
Phone number: 208-236-5215
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Mailing Address
Mr. BRADLEY L WALKER
5033 REDFISH ST
CHUBBUCK, ID 83202-3031
Phone number: 208-237-8376
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