Individual
DR. BRADLEY DOUGLAS LIDVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2220 E 53RD ST, DAVENPORT, IA 52807-2704
(480) 200-2983
Mailing address
28010 238TH ST, LE CLAIRE, IA 52753-9126
(480) 200-2983
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
101934
IA
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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