Individual
MR. BRADLEY A MCMATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2100 WATER ST, PORT HURON, MI 48060-2543
(810) 982-2700
(810) 982-5194
Mailing address
2100 WATER ST, PORT HURON, MI 48060-2543
(810) 982-2700
(810) 982-5194
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
BM006038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383199852
TAX I.D.
MI
01
—
950G45234
BCBS OF MI
MI
01
—
BM006038
MI LICENSE
MI
Enumeration date
01/05/2007
Last updated
09/17/2013
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