NPI 1619747334

Michael Bradshaw

Practitioner Supports Brokerage Agency Altoona, PA

Practice location

Address: 1548 Walton Ave, Altoona, PA 16602-4617
Phone: (412) 514-2394

Registered specialties

Supports Brokerage Agency Primary

Agencies Taxonomy 251X00000X

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Registry record

NPI: 1619747334
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Jan 2024
Record last updated: 3 Jan 2024

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.