Provider Demographics
NPI:1679961890
Name:BRADMAN CHIROPRACTIC PC
Entity Type:Organization
Organization Name:BRADMAN CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-343-6060
Mailing Address - Street 1:352 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1337
Mailing Address - Country:US
Mailing Address - Phone:585-343-6060
Mailing Address - Fax:585-344-8685
Practice Address - Street 1:352 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1337
Practice Address - Country:US
Practice Address - Phone:585-343-6060
Practice Address - Fax:585-344-8685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty