MS. Carol Corinne Bradford, LMP

NPI #1962534891 in Moscow, Idaho

Provider Information

NPI Number: 1962534891
Entity Type: Individual
Name: MS. Carol Corinne Bradford, LMP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMP
Enumeration Date: Mar 9, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 106 E 3RD ST
Address 2: SUITE 5A
City: Moscow
State: Idaho
ZIP Code: 83843-2970
Phone: (208) 883-5856

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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