Individual
DR. BONNIE G BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
772 MADDOX DR, SUITE 132, EAST ELLIJAY, GA 30540-8194
(706) 276-4455
(706) 276-4458
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001314
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00514599A
—
GA
Enumeration date
06/08/2005
Last updated
12/05/2024
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