| Doctor Name: | BRADLEY GRGURICH |
| NPI Number: | 1235497918 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 11080 |
| Business Practice Address: | 2144 Main St Suite 3 Longmont, CO - 805018402 |
| Business Phone Number: | 3036787170 |
| Business Fax Number: | 3036787134 |
| Mailing Address: | 2144 N Main Street, Suite 3 LONGMONT |
| State: | CO |
| Postal Code: | 80503 |
| Phone Number: | 3036787170 |
| Fax Number: | 3036787134 |
| NPI Enumeration Date: | 05/01/2012 |
| NPI Last Update Date: | 08/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 11080 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |