Provider Demographics
NPI:1184767493
Name:KIRZNER, BRADLEY F (DC)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:F
Last Name:KIRZNER
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 1:1133 MACARTHUR DR.
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303
Mailing Address - Country:US
Mailing Address - Phone:318-561-6250
Mailing Address - Fax:318-561-6252
Practice Address - Street 1:1133 MACARTHUR DR
Practice Address - Street 2:SUITE B
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3123
Practice Address - Country:US
Practice Address - Phone:318-561-6250
Practice Address - Fax:318-561-6252
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
669050OtherACN
5827464OtherCIGNA
203882620OtherUNITED HEALTH CARE
1900H3438ZOtherBLUE CROSS BLUE SHIED FED
H3438OtherBLUE CROSS BLUE SHIED
669050OtherACN
H3438OtherBLUE CROSS BLUE SHIED