Individual
JOHN HOWARD BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
11 CENTRE ST, SUITE 6&7, SALEM, CT 06420-3844
(860) 949-2561
(860) 471-8388
Mailing address
11 COTTAGE RD, BOZRAH, CT 06334-1412
(860) 608-2773
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006963
CT
225100000X
Physical Therapist
8020
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004221868-02
—
CT
Enumeration date
08/21/2006
Last updated
06/29/2011
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