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Individual

MS. TRICIA BRADFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1253 EASTOVER DR, JACKSON, MS 39211-6315
(601) 984-8036
(601) 984-8030
Mailing address
1253 EASTOVER DR, JACKSON, MS 39211-6315
(601) 984-8036
(601) 984-8030

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AO661
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00076026
MS
Enumeration date
12/21/2007
Last updated
12/21/2007
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