Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 038013153 | IL |
Y | 111N00000X | Chiropractor | B01783 | NV |
NPI | 1003326588 |
---|---|
Provider Name | Dr. Brad Partridge |
First Address | West Point, UT 84015-8156 |
Second Address | Henderson, NV 89014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2017 |
Last Update Date | 19/08/2019 |