Provider Demographics
NPI:1932712429
Name:BRADSHAW, JOSH
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:BRADSHAW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 EAST DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3183
Mailing Address - Country:US
Mailing Address - Phone:614-436-7837
Mailing Address - Fax:
Practice Address - Street 1:445 EAST DUBLIN GRANVILLE RD.
Practice Address - Street 2:BUILDING G
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3183
Practice Address - Country:US
Practice Address - Phone:614-436-7837
Practice Address - Fax:614-515-5779
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator