MEDICARE: MRS. EMILY BRADSHAW DPT

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
1	2251P0200X	Pediatric Physical Therapist	PT26379	FL
2	225100000X	Physical Therapist	P18968	NC

General Provider Information

NPI Number	:	1396030128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY BRADSHAW DPT

Provider Business Mailing Address
First Line	:	4602 CUMBERLAND RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-2412
Country	:	US
Telephone Number	:	843-810-5461
Fax Number	:

Provider Business Practice Location Address
First Line	:	WOMACK ARMY MEDICAL CENTER 2817 ROCK MERRITT AVE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-2877
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:	910-907-6069

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	08/25/2025

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