Provider Demographics
NPI:1629622808
Name:MYERS, BRADFORD J (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:J
Last Name:MYERS
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 1:800 TARPON WOODS BLVD STE F5
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2000
Mailing Address - Country:US
Mailing Address - Phone:727-785-2771
Mailing Address - Fax:
Practice Address - Street 1:800 TARPON WOODS BLVD STE F5
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2000
Practice Address - Country:US
Practice Address - Phone:727-785-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor