Individual
DR. BRAD ALAN SHALLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
120 S WOODLAND BLVD, SUITE B, DELAND, FL 32720-5445
(386) 341-1404
Mailing address
918 TALL PINE DR, PORT ORANGE, FL 32127-4828
(910) 231-3457
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH11338
FL
Other
Enumeration date
01/24/2015
Last updated
01/24/2015
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