Provider Demographics
NPI:1134408768
Name:BRADLEY, WILLIAM A III (DPT)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:BRADLEY
Suffix:III
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:8390 HIGHWAY 51 NORTH
Mailing Address - Street 2:101
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-1632
Mailing Address - Country:US
Mailing Address - Phone:901-872-6422
Mailing Address - Fax:901-872-6497
Practice Address - Street 1:8390 HIGHWAY 51 NORTH
Practice Address - Street 2:101
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-1632
Practice Address - Country:US
Practice Address - Phone:901-872-6422
Practice Address - Fax:901-872-6497
Is Sole Proprietor?:No
Enumeration Date:2011-08-13
Last Update Date:2014-10-23
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Provider Licenses
StateLicense IDTaxonomies
TN9062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist