Provider Demographics
NPI:1609602994
Name:VIRKLER, BRADLEY JAMES
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:JAMES
Last Name:VIRKLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1473 195TH AVE
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-8222
Mailing Address - Country:US
Mailing Address - Phone:515-238-9010
Mailing Address - Fax:641-342-1017
Practice Address - Street 1:1473 195TH AVE
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-8222
Practice Address - Country:US
Practice Address - Phone:515-238-9010
Practice Address - Fax:641-342-1017
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health