Provider Demographics
NPI:1952520199
Name:BOURNE, BRAD ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:ALAN
Last Name:BOURNE
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 1:8156 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
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor