Individual
MADISON ASHLEE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108
(801) 581-7766
Mailing address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108-1261
(801) 581-7766
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13557217-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2021
Last updated
12/08/2024
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