Healthcare Provider Details

I. General information

NPI: 1306785142
Provider Name (Legal Business Name): BRADLEY KURT DANIELS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 S 200 E
BRIGHAM CITY UT
84302-3387
US

IV. Provider business mailing address

1902 S 1275 W
SYRACUSE UT
84075-9814
US

V. Phone/Fax

Practice location:
  • Phone: 435-723-0517
  • Fax:
Mailing address:
  • Phone: 801-918-2981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9162475-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: