MEDICARE: DR. BRAD J. DUNLAP DC

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-010559	NY
2	111N00000X	Chiropractor	X-010559-1	NY

General Provider Information

NPI Number	:	1942273842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRAD J. DUNLAP DC

Provider Business Mailing Address
First Line	:	2701 ST. HWY 29
Second Line	:
City	:	JOHNSTOWN
State	:	NY
Zip	:	12095
Country	:	US
Telephone Number	:	518-725-4114
Fax Number	:	518-725-4115

Provider Business Practice Location Address
First Line	:	2701 ST. HWY 29
Second Line	:
City	:	JOHNSTOWN
State	:	NY
Zip	:	12095-4042
Country	:	US
Telephone Number	:	518-725-4114
Fax Number	:	518-725-4115

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	08/05/2010

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