Individual
DR. BRADLEY DEAN VANDYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1779 LOVERS GAP ROAD, VANSANT, VA 24656
(276) 597-8387
(276) 597-2154
Mailing address
PO BOX 855, VANSANT, VA 24656-0855
(276) 597-8387
(276) 597-2154
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
0104001184
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7600037000
—
WV
Enumeration date
02/14/2006
Last updated
11/28/2011
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