Individual
DR. BRADLEY PAUL KRISTIANSEN II
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4005 WILSON AVE SW, CEDAR RAPIDS, IA 52404-6340
(319) 396-6838
Mailing address
4005 WILSON AVE SW, CEDAR RAPIDS, IA 52404-6340
(319) 396-6838
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4485
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099739
—
IA
01
—
41643
IOWA BLUE CROSS BLUE SHIE
IA
Enumeration date
05/18/2006
Last updated
07/09/2007
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