Individual
BRADLEY ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
514 S BROWN ST, SPRINGFIELD, TN 37172-2937
(615) 988-4552
Mailing address
PO BOX 1637, SPRINGFIELD, TN 37172-1637
(615) 988-4552
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
13844
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13844
STATE LICENSE
TN
Enumeration date
08/22/2021
Last updated
08/22/2021
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