Provider Demographics
NPI:1487619086
Name:HILTY, BRADFORD J (ATC)
Entity type:Individual
Prefix:
First Name:BRADFORD
Middle Name:J
Last Name:HILTY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 KUNGLE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:44216-9341
Mailing Address - Country:US
Mailing Address - Phone:330-665-8200
Mailing Address - Fax:330-665-8197
Practice Address - Street 1:4125 MEDINA RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2483
Practice Address - Country:US
Practice Address - Phone:330-665-8200
Practice Address - Fax:330-665-8197
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0008972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer