Healthcare Provider Details
I. General information
NPI: 1811644859
Provider Name (Legal Business Name): BUGG CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2022
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1235 INDIANA CT STE 105
REDLANDS CA
92374-4540
US
IV. Provider business mailing address
34595 AVENUE H
YUCAIPA CA
92399-5325
US
V. Phone/Fax
- Phone: 909-793-4515
- Fax:
- Phone: 909-260-1367
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SETH
BUGG
Title or Position: PRESIDENT/OWNER
Credential: DC
Phone: 909-260-1367