Individual
MR. ROBERT CHASE BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
209 EVANS AVE, MOUNT STERLING, KY 40353-9700
(859) 498-0011
(859) 498-5001
Mailing address
209 EVANS AVE, MOUNT STERLING, KY 40353-9700
(859) 498-0011
(859) 498-5001
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A03422
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A03976
PTA LISCENSE
KY
Enumeration date
07/19/2019
Last updated
07/19/2019
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