Individual
BRADLEY JOHANNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4505 ALGONQUIN DR STE C, CEDAR FALLS, IA 50613-1219
(319) 553-6241
Mailing address
4505 ALGONQUIN DR STE C, CEDAR FALLS, IA 50613-1219
(319) 553-6241
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
099761
IA
111N00000X
Chiropractor
2301010622
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2301010622
—
MI
Enumeration date
12/05/2017
Last updated
03/15/2021
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