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General NPI Number Information
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NPI Number | 1285846204
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Entity Type | Individual
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Provider Name | LAURA R BRADFORD LMT
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1107 E SILVER SPRINGS BLVD SUITE 4
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City | OCALA
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State | FL
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Zip | 34470-6758
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Country | US
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Telephone | 352-840-7119
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Fax | 352-840-7119
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Provider Business Mailing Address
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Address Line | 222 SE WENONA AVE
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City | OCALA
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State | FL
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Zip | 34471-2219
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Country | US
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Telephone | 352-875-3372
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Fax | 352-840-7119
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA42290
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License Number State | FL
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