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NPI 1952520199

NPI 1952520199 : BRAD ALAN BOURNE D.C. : LITTLETON, CO

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General NPI Number Information
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    NPI Number           |    1952520199
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    Entity Type          |    Individual 
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    Provider Name        |    BRAD ALAN BOURNE D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/25/2007
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    Last Update Date     |    02/05/2014
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Provider Practice Location Address
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    Address Line         |    8156 S WADSWORTH BLVD UNIT G
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    City                 |    LITTLETON
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    State                |    CO
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    Zip                  |    80128-9114
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    Country              |    US
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    Telephone            |    303-346-8362
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    Fax                  |    303-932-1019
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Provider Business Mailing Address
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    Address Line         |    8156 S WADSWORTH BLVD UNIT G
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    City                 |    LITTLETON
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    State                |    CO
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    Zip                  |    80128-9114
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    Country              |    US
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    Telephone            |    303-346-8362
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    Fax                  |    303-932-1019
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    6042
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    License Number State |    CO
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