Provider Demographics
NPI:1336151919
Name:TURNER, BRAD J (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:J
Last Name:TURNER
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 1:1736 ADDISON AVE E
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5301
Mailing Address - Country:US
Mailing Address - Phone:208-736-1944
Mailing Address - Fax:208-736-1952
Practice Address - Street 1:1736 ADDISON AVE E
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5301
Practice Address - Country:US
Practice Address - Phone:208-736-1944
Practice Address - Fax:208-736-1952
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1672550Medicare ID - Type Unspecified
IDU18646Medicare UPIN