Individual
MR. BRADLEY PHILLIP HARDESTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
3650 MANSELL RD STE 300, ALPHARETTA, GA 30022-3068
(877) 896-3660
Mailing address
8306 SATURN PL, EL PASO, TX 79904-2525
(605) 431-0709
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1141208
TX
225100000X
Physical Therapist
1175
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4996113
BLUE CROSS BLUE SHIELD
SD
05
—
5834140
—
SD
Enumeration date
06/30/2006
Last updated
09/11/2025
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