Individual
MRS. GRACE KATHERINE BRADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1115 BOULDERS PKWY STE 110, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-6517
Mailing address
2208 MENDOTA DR, RICHMOND, VA 23229-3345
(804) 523-0397
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002710
VA
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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