Bradley Johannsen, DC | |
4505 Algonquin Dr Ste C, Cedar Falls, IA 50613-1219 | |
(319) 553-6241 | |
Not Available |
Full Name | Bradley Johannsen |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 4505 Algonquin Dr Ste C, Cedar Falls, Iowa |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871008409 | NPI | - | NPPES |
2301010622 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2301010622 (Michigan) | Secondary |
111N00000X | Chiropractor | 099761 (Iowa) | Primary |
Provider Name | Thrive Family Chiropractic Pllc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1053812511 PECOS PAC ID: 0941561500 Enrollment ID: O20180223000882 |
Mailing Address | Practice Location Address |
---|---|
Bradley Johannsen, DC 4505 Algonquin Dr Ste C, Cedar Falls, IA 50613-1219 Ph: (319) 553-6241 | Bradley Johannsen, DC 4505 Algonquin Dr Ste C, Cedar Falls, IA 50613-1219 Ph: (319) 553-6241 |
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