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Individual

BRADLEY JON WADINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMP

Contact information

Practice address
2315 ASHEVILLE HWY, UNIT 10, HENDERSONVILLE, NC 28791-1500
(828) 697-8686
(828) 697-0960
Mailing address
2315 ASHEVILLE HWY, UNIT 10, HENDERSONVILLE, NC 28791-1500
(828) 697-8686
(828) 697-0960

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
488
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
488
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
488
STATE LICENSE
NC
05
790805J
NC
Enumeration date
05/31/2006
Last updated
03/11/2008
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