Individual
KIRSTEN ANDREA BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
747 S BECKHAM AVE, TYLER, TX 75701
(903) 705-4232
Mailing address
5348 OLD JACKSONVILLE HWY. APT 206, TYLER, TX 75703
(806) 471-9826
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2102336
TX
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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