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NPI Code Detail

MEDICARE: BRADLEY I MANDELL D.C.

MEDICARE:   BRADLEY I MANDELL  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
1111NX0800XOrthopedic Chiropractor3020SC

General Provider Information

NPI Number : 1194720458
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY I MANDELL D.C.
Provider Business Mailing Address
First Line : 3629 SUZANNE DR
Second Line :
City : LITTLE RIVER
State : SC
Zip : 29566-9318
Country : US
Telephone Number : 843-957-0943
Fax Number :
Provider Business Practice Location Address
First Line : 3629 SUZANNE DR
Second Line :
City : LITTLE RIVER
State : SC
Zip : 29566-9318
Country : US
Telephone Number : 843-957-0943
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 09/19/2019

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Directions to “ BRADLEY I MANDELL D.C.” Practice Location

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