Healthcare Provider Details

I. General information

NPI: 1952302820
Provider Name (Legal Business Name): BRADLEY ANDREW ALDERTON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 10/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 210TH ST
WASHINGTON IA
52353-9226
US

IV. Provider business mailing address

2616 210TH ST
WASHINGTON IA
52353-9226
US

V. Phone/Fax

Practice location:
  • Phone: 319-653-7200
  • Fax: 319-653-7200
Mailing address:
  • Phone: 319-653-7200
  • Fax: 319-653-7200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06635
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: