Provider Demographics
NPI:1144584277
Name:HARDY, BRYCE LELAND (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:LELAND
Last Name:HARDY
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 1:18660 N CAVE CREEK RD
Mailing Address - Street 2:APT #110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-4617
Mailing Address - Country:US
Mailing Address - Phone:801-787-0848
Mailing Address - Fax:
Practice Address - Street 1:40 N CENTRAL AVE
Practice Address - Street 2:SUITE #775
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4424
Practice Address - Country:US
Practice Address - Phone:602-889-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2013-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor