Individual
VICTORIA BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2019 BOWMAN ST, SHREVEPORT, LA 71101-2001
(318) 347-2105
(318) 226-5994
Mailing address
2019 BOWMAN ST, SHREVEPORT, LA 71101-2001
(318) 347-2105
(318) 226-5994
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200150212
LA
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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