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General NPI Number Information
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NPI Number | 1104353895
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Entity Type | Organization
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Legal Business Name | DR BRADLEY WOLFF D C A PROFESSIONAL CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 1900 E TAHQUITZ CANYON WAY STE C1
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City | PALM SPRINGS
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State | CA
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Zip | 92262-7062
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Country | US
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Telephone | 760-327-3330
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Fax | 760-327-3486
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Provider Business Mailing Address
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Address Line | 1900 E TAHQUITZ CANYON WAY C1
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City | PALM SPRINGS
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State | CA
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Zip | 92262-7024
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Country | US
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Telephone | 760-327-3330
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. BRADLEY EVAN WOLFF
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Credential | DC
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Telephone | 760-327-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC18698
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License Number State | CA
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