# BRADLEY R RALSTON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912945536
- **Gender:** Man
- **Credential:** D.C.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 08001899A | IN | — |
| 111NN0400X | Neurology Chiropractor | 08001899A | IN | Yes |

## Other

- **Enumeration date:** 06/04/2006
- **Last updated:** 09/27/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000198956 | BLUE CROSS/BLUE SHIELD | — |
| 05 | — | 200363370A | — | IN |