Provider Demographics
NPI:1093842692
Name:QUICK, BRADLEY KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:KEITH
Last Name:QUICK
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 1:10442 MONOGRAM AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6755
Mailing Address - Country:US
Mailing Address - Phone:818-652-5763
Mailing Address - Fax:
Practice Address - Street 1:10442 MONOGRAM AVE
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6755
Practice Address - Country:US
Practice Address - Phone:818-652-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15356111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic