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General NPI Number Information
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NPI Number | 1336408327
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Entity Type | Individual
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Provider Name | BRAD A ROY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 205 SUNNYVIEW LN
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City | KALISPELL
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State | MT
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Zip | 59901-3120
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Country | US
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Telephone | 406-751-4512
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Fax | 406-751-4101
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Provider Business Mailing Address
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Address Line | 205 SUNNYVIEW LN
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City | KALISPELL
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State | MT
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Zip | 59901-3120
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Country | US
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Telephone | 406-751-4512
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Fax | 406-751-4101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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