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NPI Code Detail

MEDICARE: VICTORIA ERIN BRADLEY

MEDICARE: VICTORIA ERIN BRADLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant259924KY

General Provider Information

NPI Number : 1851096812
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA ERIN BRADLEY
Provider Business Mailing Address
First Line : 298 MEDLEY CT
Second Line :
City : VINE GROVE
State : KY
Zip : 40175-8421
Country : US
Telephone Number : 270-352-1133
Fax Number :
Provider Business Practice Location Address
First Line : 298 MEDLEY CT
Second Line :
City : VINE GROVE
State : KY
Zip : 40175-8421
Country : US
Telephone Number : 270-352-1133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2023
Last Update Date : 03/31/2023

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Directions to “ VICTORIA ERIN BRADLEY ” Practice Location

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