Individual
MADONNA NACOLE HOWERTON-BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
176W UNIVERSITY PKWY C, JACKSON, TN 38305-1618
(731) 660-6915
(731) 668-4557
Mailing address
176W UNIVERSITY PKWY C, JACKSON, TN 38305-1618
(731) 660-6915
(731) 668-4557
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7453
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q000202
—
TN
Enumeration date
12/20/2006
Last updated
09/24/2015
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