Provider Demographics
NPI:1639349772
Name:BRADLEY, DONNA LEE (RPT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PAYSON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1309
Mailing Address - Country:US
Mailing Address - Phone:781-551-5812
Mailing Address - Fax:508-698-8671
Practice Address - Street 1:15 PAYSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1309
Practice Address - Country:US
Practice Address - Phone:781-551-5812
Practice Address - Fax:508-698-8671
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPT6474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist