Provider Demographics
NPI:1134860596
Name:NEITZEL, BRAD F (DC)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:F
Last Name:NEITZEL
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 1:2205 N SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-3310
Mailing Address - Country:US
Mailing Address - Phone:608-244-0044
Mailing Address - Fax:608-244-2773
Practice Address - Street 1:2205 N SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3310
Practice Address - Country:US
Practice Address - Phone:608-244-0044
Practice Address - Fax:608-244-2773
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5708-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor