Individual
BRADLEY J DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
814 HIGHWAY 36, FRENCHBURG, KY 40322-8124
(606) 393-0953
Mailing address
15 APEX DR, HIGHLAND, IL 62249-1282
(618) 441-0482
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004717
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000199364
BC OF PARIS
KY
01
—
000000333709
BC HPTA
KY
Enumeration date
06/12/2006
Last updated
05/30/2017
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