Polen, Bradley Jack

Polen, Bradley Jack is an sole proprietor health care provider with primary practice located at 203 S 6Th St , Wood River IL 62095-2345. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Polen, Bradley Jack can be contacted via phone (618) 254-9355.

Contact Information

Primary practice address
203 S 6Th St Wood River IL 62095-2345
Phone: (618) 254-9355
Fax: (618) 254-9351
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 2021016090 Missouri
Chiropractic Providers / Chiropractor 111N00000X 038.013756 Illinois

Profile Details

NPI number 1043894165
LBN Legal business name Polen, Bradley Jack
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 6th, 2021
Last updated Oct 19th, 2021 - about 3 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.

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