Provider Demographics
NPI:1609883941
Name:COMBS, W BRADFORD (DC)
Entity Type:Individual
Prefix:DR
First Name:W BRADFORD
Middle Name:
Last Name:COMBS
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 1:3438 WHISKEY ROAD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803
Mailing Address - Country:US
Mailing Address - Phone:803-644-9600
Mailing Address - Fax:803-644-8888
Practice Address - Street 1:3438 WHISKEY ROAD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803
Practice Address - Country:US
Practice Address - Phone:803-644-9600
Practice Address - Fax:803-644-8888
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2983111N00000X
SC4248225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU72855Medicare UPIN