Individual
CLASSIE BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
810 VALENCIA ST, JACKSON, MS 39204-4744
(601) 405-3831
Mailing address
810 VALENCIA ST, JACKSON, MS 39204-4744
(601) 405-3831
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
—
MS
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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