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Individual

BRADLEY KERR BRYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS,PT, CHT

Contact information

Practice address
500 HIOAKS RD, SUITE B, RICHMOND, VA 23225-4061
(804) 330-8165
(804) 330-5829
Mailing address
1115 BOULDERS PKWY, STE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 915-4602
(804) 327-8496

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305001814
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010067286
VA
01
194769
ANTHEM CHIPPENHAM OT
VA
01
258462
SOUTHERN HEALTH
VA
01
98999
OPTIMA HEALTH
VA
Enumeration date
06/19/2006
Last updated
05/18/2020
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