Individual
MR. BRADLEY REDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5555
Mailing address
205 FOWLER ST, HINESVILLE, GA 31313-2118
(912) 271-7483
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN061521
GA
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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