Provider Demographics
NPI:1952302820
Name:ALDERTON, BRADLEY ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:ANDREW
Last Name:ALDERTON
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 1:2616 210TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-9226
Mailing Address - Country:US
Mailing Address - Phone:319-653-7200
Mailing Address - Fax:319-653-7200
Practice Address - Street 1:2616 210TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-9226
Practice Address - Country:US
Practice Address - Phone:319-653-7200
Practice Address - Fax:319-653-7200
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAU98809Medicare UPIN
IAI11434Medicare ID - Type UnspecifiedGROUP MEDICARE
IAI11436Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE