Provider Demographics
NPI:1699953760
Name:HANDELAND, BRADLEY KENNETH (DC, CKTP)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:KENNETH
Last Name:HANDELAND
Suffix:
Gender:M
Credentials:DC, CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 10TH ST STE 7
Mailing Address - Street 2:HANDELAND CHIROPRACTIC
Mailing Address - City:CLARKFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:56223-1304
Mailing Address - Country:US
Mailing Address - Phone:612-581-2907
Mailing Address - Fax:
Practice Address - Street 1:920 10TH ST STE 7
Practice Address - Street 2:HANDELAND CHIROPRACTIC
Practice Address - City:CLARKFIELD
Practice Address - State:MN
Practice Address - Zip Code:56223-1304
Practice Address - Country:US
Practice Address - Phone:612-581-2907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor