MEDICARE: DR. BRADLEY PAUL BURKE 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	7098	AZ

General Provider Information

NPI Number	:	1841234036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY PAUL BURKE D.C.

Provider Business Mailing Address
First Line	:	13350 S SUNLAND GIN RD
Second Line	:	SUITE B4
City	:	ARIZONA CITY
State	:	AZ
Zip	:	85223-0789
Country	:	US
Telephone Number	:	520-494-1000
Fax Number	:	520-494-1001

Provider Business Practice Location Address
First Line	:	13350 S SUNLAND GIN RD
Second Line	:
City	:	ARIZONA CITY
State	:	AZ
Zip	:	85223-0789
Country	:	US
Telephone Number	:	520-494-1000
Fax Number	:	520-494-1001

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	07/09/2007

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