Individual
MR. BRADLEY HAMILTON BRISCOE
Active
Individual
MR. BRADLEY HAMILTON BRISCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
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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