Provider Demographics
NPI:1982838710
Name:HARRYMAN, BRADLEY DAHLEM (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:DAHLEM
Last Name:HARRYMAN
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 1:9235 E HARRY ST STE 30
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-5073
Mailing Address - Country:US
Mailing Address - Phone:316-685-0020
Mailing Address - Fax:
Practice Address - Street 1:9235 E HARRY ST STE 30
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5073
Practice Address - Country:US
Practice Address - Phone:316-685-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010079111N00000X
KS01-06224111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor