Individual
EMALY ELIZABETH BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1180 RESURGENCE DR STE 100, WATKINSVILLE, GA 30677-7211
(706) 204-1694
Mailing address
1180 RESURGENCE DR STE 100, WATKINSVILLE, GA 30677-7211
(706) 204-1694
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12758
GA
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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