Individual
LAUREL BRADHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 OLD CHEROKEE RD, LEXINGTON, SC 29072-9406
(803) 490-0960
Mailing address
172 BONHOMME CIR, LEXINGTON, SC 29072-8695
(803) 422-8990
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4824
SC
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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