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General NPI Number Information
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NPI Number | 1578706149
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Entity Type | Organization
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Legal Business Name | DAVID B. BRADLEY, DC, PC
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 729 W. BEDFORD-EULESS RD STE 209
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City | HURST
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State | TX
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Zip | 76053-3941
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Country | US
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Telephone | 817-282-7600
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Fax | 817-282-7604
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Provider Business Mailing Address
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Address Line | 729 W. BEDFORD-EULESS RD STE 209
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City | HURST
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State | TX
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Zip | 76053-3941
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Country | US
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Telephone | 817-282-7600
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Fax | 817-282-7604
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. DAVID B BRADLEY
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Credential | D.C.
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Telephone | 817-282-7600
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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 | 4202
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License Number State | TX
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