Individual
DR. BRADFORD LEWIS SHULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
202 S INDIANA ST, NEVADA, MO 64772-3978
(417) 667-4322
(417) 667-8997
Mailing address
202 S INDIANA ST, NEVADA, MO 64772-3978
(417) 667-4322
(417) 667-8997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
005736
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001389
MEDICARE PTAN
MO
01
—
1457357840
NPI
MO
01
—
16346025
BCBS
MO
Enumeration date
06/22/2005
Last updated
08/18/2010
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