Individual
WHITNEY ROSE BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
123 JEFFERSON DAVIS BLVD, NATCHEZ, MS 39120-5103
(601) 445-0005
(601) 445-0370
Mailing address
123 JEFFERSON DAVIS BLVD, NATCHEZ, MS 39120-5103
(601) 445-0005
(601) 445-0370
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
08093
LA
225100000X
Physical Therapist
Primary
PT4941
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08093
LICENSE - LOUISIANA
LA
01
—
PT4941
LICENSE
MS
Enumeration date
06/29/2011
Last updated
06/29/2011
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