Provider Demographics
NPI:1659503456
Name:GORSKI, BRADLEY ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:ROBERT
Last Name:GORSKI
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 1:1662 SAVANNAH HWY STE 115
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-2255
Mailing Address - Country:US
Mailing Address - Phone:269-277-4344
Mailing Address - Fax:
Practice Address - Street 1:1662 SAVANNAH HWY STE 115
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-2255
Practice Address - Country:US
Practice Address - Phone:269-277-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor