Healthcare Provider Details

I. General information

NPI: 1548342272
Provider Name (Legal Business Name): BRADLEY D DASHER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 SOUTH EDGERTON
BRECKSVILLE OH
44141
US

IV. Provider business mailing address

2132 CASE PARKWAY N SUITE A
TWINSBURG OH
44087
US

V. Phone/Fax

Practice location:
  • Phone: 440-746-1730
  • Fax: 440-746-1732
Mailing address:
  • Phone: 330-963-2920
  • Fax: 330-963-2921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number000269
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number006253
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: