Individual
JENNA KAITLYN BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
554 N STEELHEAD WAY STE 162, BOISE, ID 83704-8388
(208) 323-9747
(208) 323-9752
Mailing address
554 N STEELHEAD WAY STE 162, BOISE, ID 83704-8388
(208) 323-9747
(208) 323-9752
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-8840
ID
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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