Provider Demographics
NPI:1669672895
Name:BRAD BOURNE PC
Entity type:Organization
Organization Name:BRAD BOURNE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT (CHIROPRACTOR)
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-346-8362
Mailing Address - Street 1:8156 S WADSWORTH BLVD
Mailing Address - Street 2:UNIT G
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-9114
Mailing Address - Country:US
Mailing Address - Phone:303-346-8362
Mailing Address - Fax:303-932-1019
Practice Address - Street 1:8156 S WADSWORTH BLVD
Practice Address - Street 2:UNIT G
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-9114
Practice Address - Country:US
Practice Address - Phone:303-346-8362
Practice Address - Fax:303-932-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty