Provider Demographics
NPI:1619912698
Name:KAPPEL, BRADLEY J (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:J
Last Name:KAPPEL
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:#7 CHARLOTTE AMALIE
Mailing Address - Street 2:STE D
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802
Mailing Address - Country:US
Mailing Address - Phone:340-714-2225
Mailing Address - Fax:727-231-8188
Practice Address - Street 1:#7 CHARLOTTE AMALIE
Practice Address - Street 2:STE D
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-714-2225
Practice Address - Fax:727-231-8188
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI34-C111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI605762200OtherUS DEPT OF LABOR (FED WC)
VI66-0650126OtherTAX ID
VI5-3562Medicare ID - Type UnspecifiedMEDICARE TRIPLE S-PARTB