Provider Demographics
NPI:1992804728
Name:TEMPLE, BRAD LEE (DO)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:LEE
Last Name:TEMPLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 HAGEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-1123
Mailing Address - Country:US
Mailing Address - Phone:785-823-3008
Mailing Address - Fax:785-823-0985
Practice Address - Street 1:1909 HAGEMAN AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-1123
Practice Address - Country:US
Practice Address - Phone:785-823-3008
Practice Address - Fax:785-823-0985
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor