Colton Bradfield, DPT

Individual provider Active NPI Physical Therapist · Clinton, TN

NPI 1467060418 · NPPES record last updated Jan 23, 2023

Key facts

NPI
1467060418
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
26619 (MA)
Practice address
1202 N Charles G Seivers Blvd Ste a
Clinton, TN 37716-3936
Phone
(865) 457-0192
NPI assigned
Jul 15, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
12902TNMDDentist
CP011852TAZMDPhysical Therapist
26619MAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP011852T AZ
Physical Therapist 225100000X
Physical Therapist 225100000X 12902 TN
Physical Therapist 225100000X 26619 MA Yes

Addresses

Primary practice location

1202 N Charles G Seivers Blvd Ste a
Clinton, TN 37716-3936

Mailing address

1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424
Phone (423) 238-8923

Other providers in Clinton, TN

All providers in Clinton, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.