Individual
BRADLEY MICHAEL MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
5440 LOUISE RD, CUMBERLAND FURNACE, TN 37051-9064
(210) 240-2723
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/22/2010
Last updated
04/22/2010
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