Provider Demographics
NPI:1376668327
Name:PASTRO, BRADLEY RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:RICHARD
Last Name:PASTRO
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 1:3232 CARMINE ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-1831
Mailing Address - Country:US
Mailing Address - Phone:775-883-4114
Mailing Address - Fax:775-883-4770
Practice Address - Street 1:3232 CARMINE ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-1831
Practice Address - Country:US
Practice Address - Phone:775-883-4114
Practice Address - Fax:775-883-4770
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVDC539Medicare PIN