Provider Demographics
NPI:1093082737
Name:POFF, BRADLEY C (DVM)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:C
Last Name:POFF
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1468 SOUTHRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-1128
Mailing Address - Country:US
Mailing Address - Phone:978-790-2226
Mailing Address - Fax:
Practice Address - Street 1:1468 SOUTHRIDGE AVE
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1128
Practice Address - Country:US
Practice Address - Phone:978-790-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13588174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian