Provider Demographics
NPI:1982839965
Name:DIONNE, BRADLEY THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:THOMAS
Last Name:DIONNE
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 1:25055 N 75TH LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-6461
Mailing Address - Country:US
Mailing Address - Phone:602-258-9663
Mailing Address - Fax:
Practice Address - Street 1:4550 E BELL RD STE 152
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-9382
Practice Address - Country:US
Practice Address - Phone:602-258-9663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN24700025Medicare PIN