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General NPI Number Information
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NPI Number | 1699802405
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Entity Type | Organization
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Legal Business Name | BRADBURY PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 9018 BALBOA BLVD SUITE 547
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City | NORTHRIDGE
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State | CA
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Zip | 91325-2610
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Country | US
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Telephone | 818-434-5597
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Fax | 818-647-6158
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Provider Business Mailing Address
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Address Line | 9337 GERALD AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91343-2701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT JAMES BRADBURY
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Credential | PT
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Telephone | 818-434-5597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT 21269
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License Number State | CA
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