Individual
MR. ALEX BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Contact information
Practice address
1913 HARVARD DR, LOUISVILLE, KY 40205-1829
(502) 551-6583
Mailing address
1913 HARVARD DR, LOUISVILLE, KY 40205-1829
(502) 551-6583
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R5212
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71000000320
—
KY
Enumeration date
05/22/2015
Last updated
05/22/2015
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