MEDICARE: DR. BRAD RATSPRECHER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X-10186	NY

General Provider Information

NPI Number	:	1174678551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRAD RATSPRECHER D.C.

Provider Business Mailing Address
First Line	:	1 EXECUTIVE BLVD
Second Line	:	SUITE 205
City	:	MONTEBELLO
State	:	NY
Zip	:	10901-4180
Country	:	US
Telephone Number	:	845-623-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 EXECUTIVE BLVD
Second Line	:	SUITE 205
City	:	MONTEBELLO
State	:	NY
Zip	:	10901-4180
Country	:	US
Telephone Number	:	845-623-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	11/12/2008

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