Individual
MRS. LISA BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
349 BOGLE STREET SUITE B, SOMERSET, KY 42503-2895
(606) 485-4611
Mailing address
349 BOGLE ST, SUITE B, SOMERSET, KY 42503-2895
(606) 485-4611
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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