Individual
KATHLEEN R BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
33 SEWALL ST, PORTLAND, ME 04102-2603
(207) 828-2100
Mailing address
324 GANNETT DR STE 200, PORTLAND, ME 04106-3266
(207) 482-7800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1438
ME
Other
Enumeration date
12/17/2013
Last updated
11/09/2015
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