Individual
BRADLEY GARRETT FAIRMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
537 MAIN ST, BERLIN, PA 15530-1344
(814) 267-6440
(814) 267-6442
Mailing address
537 MAIN ST, BERLIN, PA 15530-1344
(814) 267-6440
(814) 267-6442
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC009285
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001666144
HIGHMARK PROVIDER ID
PA
Enumeration date
03/07/2007
Last updated
10/09/2014
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