Provider Demographics
NPI:1386866630
Name:BRADSHAW, MINDY HALL (DC)
Entity type:Individual
Prefix:DR
First Name:MINDY
Middle Name:HALL
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 CHATHAM DOWNS DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-6118
Mailing Address - Country:US
Mailing Address - Phone:919-969-0931
Mailing Address - Fax:
Practice Address - Street 1:141 CHATHAM DOWNS DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-6118
Practice Address - Country:US
Practice Address - Phone:919-969-0931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085VCOtherBCBS