Individual
MARTHA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
HC 35 BOX 5475A, WASILLA, AK 99654-8801
(907) 258-5665
Mailing address
HC 35 BOX 5475A, WASILLA, AK 99654-8801
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
723449
AK
251B00000X
Case Management Agency
723449
AK
Other
Enumeration date
02/22/2007
Last updated
01/08/2008
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