NPI 1013296177
Jacob Alexander Bradshaw
Practice location
- Address
- 1104 Columbia Court, Edmond, OK 73003
- Phone
- (405) 240-7003
- Mailing address
- 1104 Columbia CT, Edmond, OK 73003-6149
Registered specialties
Behavior Analyst
Primary
Registry record
- NPI
- 1013296177
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 8 Aug 2011
- Record last updated
- 8 Aug 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.