Search › Idaho › 363AM0700X
Bradley Heninger, PA-C
NPI 1205103389 · on the registry since 2011
Practice
- Address
- 910 Nw 16th Street
Ste 205
Fruitland, ID 83619 - Phone
- (208) 452-3111
- Fax
- (208) 452-3666
- Organisation at this address
- Riverside Orthopedic Clinic
Saint Alphonsus Medical Center- Ontario IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 22
Registry record
- Primary taxonomy
- 363AM0700X
363AM0700X
- Also registered as
- 363AM0700X
- Licence states on file
- OR, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-02-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho