Provider Demographics
NPI:1922302512
Name:BRADLEY, KERRY ALYSSA (DC)
Entity Type:Individual
Prefix:MISS
First Name:KERRY
Middle Name:ALYSSA
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14770 MEMORIAL DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5252
Mailing Address - Country:US
Mailing Address - Phone:281-493-5535
Mailing Address - Fax:281-493-3353
Practice Address - Street 1:14770 MEMORIAL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5252
Practice Address - Country:US
Practice Address - Phone:281-496-7333
Practice Address - Fax:281-496-7337
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor