Individual
DIANE BRADBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
55 W LAKE RD, PLEASANT HILL, TN 38578-3002
(931) 248-0291
Mailing address
234 BACKWOODS WAY, CROSSVILLE, TN 38555-6951
(931) 248-0291
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3294
TN
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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