Individual
BRADLEY SHANE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3501 SENIOR VILLAGE LN NW, WILSON, NC 27896-9618
(252) 243-3186
Mailing address
378 SANDHILL DR, GOLDSBORO, NC 27530-0906
(252) 299-0917
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12312
NC
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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