Individual
MR. BART JEROME BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 LYNN ST STE A, VIDALIA, LA 71373-3806
(614) 519-1615
Mailing address
421 MYRTLE ST, VIDALIA, LA 71373-3824
(614) 519-1615
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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