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Individual

MR. BRADLEY HAMILTON BRISCOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
1100 GLENSBORO ROAD SUITE #1, CENTRAL KENTUCKY PHYSICAL THERAPY 1NC DBA LAWRENCEBURG, LAWRENCEBURG, KY 40342-9084
(502) 839-9755
(502) 839-9763
Mailing address
1100 GLENSBORO ROAD SUITE #1, CENTRAL KENTUCKY PHYSICAL THERAPY 1NC DBA LAWRENCEBURG, LAWRENCEBURG, KY 40342-9084
(502) 839-9755
(502) 839-9763

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
A01619
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A01619
PTA LICENSE #
KY
Enumeration date
03/03/2015
Last updated
03/03/2015
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