Individual
JACKLYN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
333 BUDLONG RD, CRANSTON, RI 02920-6337
(401) 943-4530
Mailing address
333 BUDLONG RD, CRANSTON, RI 02920-6337
(401) 943-4530
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/04/2016
Last updated
01/04/2016
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