Individual
MS. PAIGE W BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS/PT
Contact information
Practice address
314 HIGHLAND PARK DR, RICHMOND, KY 40475-3487
(859) 353-5022
(859) 353-5047
Mailing address
314 HIGHLAND PARK DR, RICHMOND, KY 40475-3487
(859) 353-5022
(859) 353-5047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251P0200X
Pediatric Physical Therapist
005142
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000783289
ANTHEM PIN
KY
05
—
7100219070
—
KY
Enumeration date
12/17/2007
Last updated
12/22/2014
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