Provider Demographics
NPI:1295731297
Name:CRANWELL, BRAD L (DC)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:L
Last Name:CRANWELL
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 1:110 TRADERS LN
Mailing Address - Street 2:
Mailing Address - City:MILLIKEN
Mailing Address - State:CO
Mailing Address - Zip Code:80543-3152
Mailing Address - Country:US
Mailing Address - Phone:970-587-7029
Mailing Address - Fax:970-587-7029
Practice Address - Street 1:110 TRADERS LN
Practice Address - Street 2:
Practice Address - City:MILLIKEN
Practice Address - State:CO
Practice Address - Zip Code:80543-3152
Practice Address - Country:US
Practice Address - Phone:970-587-7029
Practice Address - Fax:970-587-7029
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5654111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NT0100XChiropractic ProvidersChiropractorThermography