Provider Demographics
NPI:1285708180
Name:DODENHOFF, BRADLEY ALVIN (DC)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:ALVIN
Last Name:DODENHOFF
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 1:2001 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4211
Mailing Address - Country:US
Mailing Address - Phone:661-633-2386
Mailing Address - Fax:661-633-2846
Practice Address - Street 1:2001 19TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4211
Practice Address - Country:US
Practice Address - Phone:661-633-2386
Practice Address - Fax:661-633-2846
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16343111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor