Provider Demographics
NPI:1790143931
Name:KNOX, BRADLEY (DC)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:KNOX
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 1:8494 S UPHAM WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-6363
Mailing Address - Country:US
Mailing Address - Phone:612-709-9280
Mailing Address - Fax:
Practice Address - Street 1:8494 S UPHAM WAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-6363
Practice Address - Country:US
Practice Address - Phone:612-709-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0007399111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor