MEDICARE: DR. JOSEPH J BRADLEY D.C., C.AD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	B00889	NV

General Provider Information

NPI Number	:	1811164080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH J BRADLEY D.C., C.AD.

Provider Business Mailing Address
First Line	:	810 S DURANGO DR
Second Line	:	SUITE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-2423
Country	:	US
Telephone Number	:	702-839-3839
Fax Number	:	702-839-3892

Provider Business Practice Location Address
First Line	:	810 S DURANGO DR
Second Line	:	SUITE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-2423
Country	:	US
Telephone Number	:	702-839-3839
Fax Number	:	702-839-3892

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2008
Last Update Date	:	05/15/2008

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