Provider Demographics
NPI:1376708743
Name:TURNER CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:TURNER CHIROPRACTIC, P.C.
Other - Org Name:BRADLEY J TURNER, D.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-736-1944
Mailing Address - Street 1:1736 ADDISON AVE E
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5301
Mailing Address - Country:US
Mailing Address - Phone:208-736-1944
Mailing Address - Fax:208-736-1952
Practice Address - Street 1:1736 ADDISON AVE E
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5301
Practice Address - Country:US
Practice Address - Phone:208-736-1944
Practice Address - Fax:208-736-1952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDC6004OtherBLUE CROSS
IDPENDINGMedicare PIN