Provider Demographics
NPI:1003241407
Name:BRADFORD, FRANCIS BLAKE (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:BLAKE
Last Name:BRADFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 W SPRING ST SE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-3686
Mailing Address - Country:US
Mailing Address - Phone:770-438-8990
Mailing Address - Fax:770-438-1650
Practice Address - Street 1:1290 W SPRING ST SE
Practice Address - Street 2:SUITE 130
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-3686
Practice Address - Country:US
Practice Address - Phone:770-438-8990
Practice Address - Fax:770-438-1650
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2015-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO009458111N00000X
MI2301010130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor