Individual
CHARLES BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
118 JOHNSON AVE, CELINA, OH 45822-1219
(419) 953-5367
Mailing address
118 JOHNSON AVE, CELINA, OH 45822-1219
(419) 953-5367
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PTA5287
ID
225200000X
Physical Therapy Assistant
2103110
TX
225200000X
Physical Therapy Assistant
Primary
PTA02163
OH
225200000X
Physical Therapy Assistant
PTA8365
AL
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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