Provider Demographics
NPI:1063242527
Name:BRADFORD, MILES ARTHUR (DC)
Entity type:Individual
Prefix:
First Name:MILES
Middle Name:ARTHUR
Last Name:BRADFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-8909
Mailing Address - Country:US
Mailing Address - Phone:510-648-8677
Mailing Address - Fax:
Practice Address - Street 1:2716 V ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-1901
Practice Address - Country:US
Practice Address - Phone:916-447-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor