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Individual
BRADLEY R RALSTON
Active
Individual
BRADLEY R RALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
08001899A
IN
111NN0400X
Neurology Chiropractor
Primary
08001899A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198956
BLUE CROSS/BLUE SHIELD
—
05
—
200363370A
—
IN
Enumeration date
06/04/2006
Last updated
09/27/2016
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