Provider Demographics
NPI:1386356384
Name:BRADLEY, ZACHERY J (PT, DPT)
Entity type:Individual
Prefix:
First Name:ZACHERY
Middle Name:J
Last Name:BRADLEY
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 1:10525 JEREMY POINTE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-5439
Mailing Address - Country:US
Mailing Address - Phone:469-586-9001
Mailing Address - Fax:
Practice Address - Street 1:11201 S EASTERN AVE STE 220
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-6202
Practice Address - Country:US
Practice Address - Phone:702-614-0324
Practice Address - Fax:702-341-0324
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist