Individual
KELLY MICHELLE BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
595 SUNNYDALE AVE, MANSFIELD, OH 44905-1436
(419) 543-6911
Mailing address
595 SUNNYDALE AVE, MANSFIELD, OH 44905-1436
(419) 543-6911
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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