Individual
DR. BRADLEY DEAN CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
3651 BYRON CENTER AVE SW, WYOMING, MI 49519-3665
(616) 530-0151
(616) 530-0205
Mailing address
3674 BLUEBIRD AVE SW, WYOMING, MI 49519-3167
(616) 249-3192
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301006548
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972685
—
MI
01
—
950D150450
BCBS
MI
Enumeration date
04/06/2007
Last updated
07/12/2010
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