Individual
GWENDOLYN BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1940 KINGS GRANT DR, AUGUSTA, GA 30906-3626
(706) 564-6729
Mailing address
1940 KINGS GRANT DR, AUGUSTA, GA 30906-3626
(706) 564-6729
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0000023113
GA
Other
Enumeration date
01/29/2014
Last updated
01/29/2014
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