Provider Demographics
NPI:1528664331
Name:GOINS, BRADLEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:GOINS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3531 SILVERADO DR
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89705-6887
Mailing Address - Country:US
Mailing Address - Phone:775-220-1709
Mailing Address - Fax:
Practice Address - Street 1:885 MAHOGANY DR
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4605
Practice Address - Country:US
Practice Address - Phone:775-400-1208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist