Provider Demographics
NPI:1316234610
Name:PICK, BRAD E (DC)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:E
Last Name:PICK
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 1:515 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2739
Mailing Address - Country:US
Mailing Address - Phone:712-792-4000
Mailing Address - Fax:712-792-3554
Practice Address - Street 1:515 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2739
Practice Address - Country:US
Practice Address - Phone:712-792-4000
Practice Address - Fax:712-792-3554
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor