Individual
GIDGETT LEANN BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
731 N GRAND AVE, MC RAE, AR 72102-9708
(501) 726-1700
Mailing address
731 N GRAND AVE, MC RAE, AR 72102-9708
(501) 726-1700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1210
AR
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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