Provider Demographics
NPI:1003800327
Name:BRADSHAW, BRIAN (MS, ATC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:BRADSHAW
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TOWSON UNIVERSITY DEPT OF ATHLETICS
Mailing Address - Street 2:8000 YORK ROAD
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21252-0001
Mailing Address - Country:US
Mailing Address - Phone:410-704-5501
Mailing Address - Fax:410-704-2727
Practice Address - Street 1:TOWSON UNIVERSITY DEPT OF ATHLETICS
Practice Address - Street 2:8000 YORK ROAD
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21252-0001
Practice Address - Country:US
Practice Address - Phone:410-704-5501
Practice Address - Fax:410-704-2727
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer