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General NPI Number Information
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NPI Number | 1053264184
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Entity Type | Individual
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Provider Name | BRADFORD BASCOM DPT
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Gender | Male
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 1041 MORGANTON BLVD SW STE 500
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City | LENOIR
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State | NC
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Zip | 28645-5605
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Country | US
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Telephone | 828-728-8317
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Fax |
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Provider Business Mailing Address
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Address Line | 806 DEVONSHIRE CT SW
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City | LENOIR
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State | NC
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Zip | 28645-5814
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Country | US
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Telephone | 828-728-8317
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P14346
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License Number State | NC
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