Individual
AMANDA JO BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1500 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4361
(231) 580-6415
Mailing address
1500 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4361
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703091932
MI
Other
Enumeration date
03/07/2022
Last updated
03/07/2022
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