Individual
TIFFANY BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
406 WYOMING RD, OWINGSVILLE, KY 40360-8906
(606) 674-6613
Mailing address
1922 HIGHWAY 1010, EZEL, KY 41425-8926
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R3069
KY
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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