Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bradford Jamal Kennebrew, PTA

Individual provider Physical Therapy Assistant · NPI 1811623242

Bradford Jamal Kennebrew, PTA is a Physical Therapy Assistant in Stone Mountain, Georgia. Licensed in Georgia. Registered with an NPI since 2022.

Licensed in
GA
In the registry since
2022
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

1227 Rockbridge Rd Ste 402
Stone Mountain, GA 30087-3006
Phone: (770) 925-9210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA003995 (GA)

Record details

NPI number1811623242
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedJuly 27, 2022
Last updated in NPPESAugust 29, 2022
Certification dateAugust 29, 2022

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