Doctor Name: | MRS. ETHEL RUTH BRADSHAW |
NPI Number: | 1750618948 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1892 West Memorial Hwy Union Grove, NC - 286899049 |
Business Phone Number: | 7045394445 |
Business Fax Number: | 7045394663 |
Mailing Address: | P.o. Box 103, UNION GROVE |
State: | NC |
Postal Code: | 286890103 |
Phone Number: | 7045394445 |
Fax Number: | 7045394663 |
NPI Enumeration Date: | 11/09/2009 |
NPI Last Update Date: | 11/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225000000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Orthotic Fitter |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |