Bradley, Marc
Bradley, Marc is an sole proprietor health care provider with primary practice located at 111 Elm Street , Weber City VA 24290. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Bradley, Marc can be contacted via phone (276) 386-7778.Contact Information
Primary practice address
111 Elm Street
Weber City VA 24290
Phone: (276) 386-7778
Fax: (276) 386-7857
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 0104556003 | Virginia |
Profile Details
| NPI number | 1861598211 |
|---|---|
| LBN Legal business name | Bradley, Marc |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861598211 | NPPES |
| Virginia | Other | 7647380 | AETNA |
| Virginia | Other | VA0104 | AETNA |
| Virginia | Other | 175344 | AETNA |
| Virginia | MEDICAID | 4047000 | AETNA |
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