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Organization
BRADLEY CHIROPRACTIC LLC
Active
Organization
BRADLEY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN P BRADLEY D.C. (OWNER)
(636) 296-1222
Entity
Organization
Contact information
Practice address
1761 JEFFCO BLVD, ARNOLD, MO 63010-2713
(636) 296-1222
(636) 296-1226
Mailing address
1761 JEFFCO BLVD, ARNOLD, MO 63010-2713
(636) 296-1222
(636) 296-1226
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2004018211
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192584
BLUE CROSS GROUP PIN
MO
01
—
DG7614
RAILROAD GROUP PIN
MO
Enumeration date
10/17/2007
Last updated
12/06/2022
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