Provider Demographics
NPI:1417067141
Name:TODARO, BRADLEY M (DC)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:M
Last Name:TODARO
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 1:4198 WASHINGTON ROAD
Mailing Address - Street 2:STE 6
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317
Mailing Address - Country:US
Mailing Address - Phone:724-942-7660
Mailing Address - Fax:724-942-7664
Practice Address - Street 1:4198 WASHINGTON ROAD
Practice Address - Street 2:STE 6
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317
Practice Address - Country:US
Practice Address - Phone:724-942-7660
Practice Address - Fax:724-942-7664
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009281111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V00922Medicare UPIN
PA098657Medicare ID - Type Unspecified