Individual
BRADLEY PHIL HAWKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
28 SHADETREE LN, GALAX, VA 24333-6015
(276) 236-1974
(276) 236-1975
Mailing address
28 SHADETREE LN, GALAX, VA 24333-6015
(276) 236-1974
(276) 236-1975
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001236
VA
Other
Enumeration date
02/24/2019
Last updated
02/24/2019
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