Provider Demographics
NPI:1053676205
Name:BRADLEY, ROBERT LITTLETON (EDD, ATC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LITTLETON
Last Name:BRADLEY
Suffix:
Gender:M
Credentials:EDD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BORDER AVE
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7387
Mailing Address - Country:US
Mailing Address - Phone:864-320-7133
Mailing Address - Fax:
Practice Address - Street 1:23 BORDER AVE
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-7387
Practice Address - Country:US
Practice Address - Phone:864-320-7133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer