Provider Demographics
NPI:1447773502
Name:BARTEL, BRADLEY W JR (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:W
Last Name:BARTEL
Suffix:JR
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 1:3628 HARDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-5938
Mailing Address - Country:US
Mailing Address - Phone:863-701-2225
Mailing Address - Fax:863-701-2221
Practice Address - Street 1:3628 HARDEN BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-5938
Practice Address - Country:US
Practice Address - Phone:863-701-2225
Practice Address - Fax:863-701-2221
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor