NPI 1831907393
Bradley Jackson
Practice location
- Address
- 2921 Randolph Rd, Janesville, WI 53545-0665
- Phone
- (608) 866-0689
- Mailing address
- 4100 Wyndham Dr NE, Cedar Rapids, IA 52402-2565
Registered specialties
Adult Companion
Primary
Registry record
- NPI
- 1831907393
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 30 Dec 2024
- Record last updated
- 7 Jan 2025
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.