Provider Demographics
NPI:1356459937
Name:HOPPER, BRADLEY JOEL (DC)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:JOEL
Last Name:HOPPER
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 1:3430 E TROPICANA AVE STE 59
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-7349
Mailing Address - Country:US
Mailing Address - Phone:702-450-5353
Mailing Address - Fax:702-450-5833
Practice Address - Street 1:3430 E TROPICANA AVE
Practice Address - Street 2:SUITE 52
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7335
Practice Address - Country:US
Practice Address - Phone:702-450-5353
Practice Address - Fax:702-450-5833
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV30575Medicare ID - Type UnspecifiedPROVIDER NUMBER