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Individual

G BRADFORD HOUSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
208 W MAIN ST, UNION CITY, TN 38261-3225
(731) 885-1144
(731) 885-1157
Mailing address
208 W MAIN ST, UNION CITY, TN 38261-3225
(731) 885-1144
(731) 885-1157

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC423
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0043951
BLUE CROSS TN PROVIDER ID
TN
Enumeration date
11/06/2006
Last updated
12/11/2007
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