Provider Demographics
NPI:1144507013
Name:MEALY, BRADLEY JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:JOSEPH
Last Name:MEALY
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 1:2129 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4743
Mailing Address - Country:US
Mailing Address - Phone:814-459-6940
Mailing Address - Fax:814-459-0211
Practice Address - Street 1:2129 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4743
Practice Address - Country:US
Practice Address - Phone:814-459-6940
Practice Address - Fax:813-459-0211
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor