Individual
JENNIFER ELAINE BRADBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6340 SUGARLOAF PKWY, SUITE 375, DULUTH, GA 30097-4333
(770) 814-2223
(770) 814-2232
Mailing address
3175 SUPERIOR DR, DACULA, GA 30019-3417
(404) 401-5812
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT001336
GA
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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