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General NPI Number Information
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NPI Number | 1477371433
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Entity Type | Individual
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Provider Name | MACKEN'Z SMITH BRADFORD AU.D.,CCC-A
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Gender | Female
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 2104 LANGHORNE RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-1424
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Country | US
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Telephone | 434-528-4245
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Fax |
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Provider Business Mailing Address
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Address Line | 970 BREWINGTON DR
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City | FOREST
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State | VA
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Zip | 24551-2488
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Country | US
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Telephone |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2201002053
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License Number State | VA
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