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General NPI Number Information
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NPI Number | 1982916391
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Entity Type | Individual
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Provider Name | BRAD D TEPPER DC
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Gender | Male
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 800 STERTHAUS DR SUITE A
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5132
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Country | US
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Telephone | 386-310-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 RIDGEWOOD AVE STE A
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City | HOLLY HILL
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State | FL
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Zip | 32117-5405
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Country | US
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Telephone | 386-310-7246
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Fax | 386-310-4952
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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 | CH10046
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License Number State | FL
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