Vandyke, Bradley Dean

Vandyke, Bradley Dean is an sole proprietor health care provider with primary practice located at 1779 Lovers Gap Road , Vansant VA 24656. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Vandyke, Bradley Dean can be contacted via phone (276) 597-8387.

Contact Information

Primary practice address
1779 Lovers Gap Road Vansant VA 24656
Phone: (276) 597-8387
Fax: (276) 597-2154
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 0104001184 Virginia

Profile Details

NPI number 1013981356
LBN Legal business name Vandyke, Bradley Dean
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 14th, 2006
Last updated Nov 28th, 2011 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1013981356 NPPES
West Virginia MEDICAID 7600037000

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