Provider Demographics
NPI:1619284288
Name:PYLE, BRADLEY A
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:A
Last Name:PYLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432
Mailing Address - Country:US
Mailing Address - Phone:785-632-5577
Mailing Address - Fax:785-632-5057
Practice Address - Street 1:720 6TH ST
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67432
Practice Address - Country:US
Practice Address - Phone:785-632-5577
Practice Address - Fax:785-632-5057
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor