Bradshaw, Laura
Bradshaw, Laura is an sole proprietor health care provider with primary practice located at 252 Latitude Ln Ste 103 , Lake Wylie SC 29710-8152. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bradshaw, Laura can be contacted via phone (803) 818-0218.Contact Information
Primary practice address
252 Latitude Ln Ste 103
Lake Wylie SC 29710-8152
Phone: (803) 818-0218
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 6812 | South Carolina |
Profile Details
| NPI number | 1538772017 |
|---|---|
| LBN Legal business name | Bradshaw, Laura |
| Credentials | MS/CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 25th, 2020 |
| Last updated | Aug 25th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538772017 | NPPES |
| South Carolina | MEDICAID | GP5559 |
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