Provider Demographics
NPI:1427270545
Name:KLOSKA, BRADLEY ARTHUR (DO)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:ARTHUR
Last Name:KLOSKA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 GERMAN ST
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48763-9349
Mailing Address - Country:US
Mailing Address - Phone:989-362-4170
Mailing Address - Fax:989-362-0034
Practice Address - Street 1:700 GERMAN ST
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9349
Practice Address - Country:US
Practice Address - Phone:989-362-4170
Practice Address - Fax:989-362-0034
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016801207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine