Healthcare Provider Details

I. General information

NPI: 1518269455
Provider Name (Legal Business Name): JOSEPH R. BUMBARGER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 6TH AVE
ALTOONA PA
16602-2324
US

IV. Provider business mailing address

1710 6TH AVE
ALTOONA PA
16602-2324
US

V. Phone/Fax

Practice location:
  • Phone: 814-895-7987
  • Fax: 814-944-5375
Mailing address:
  • Phone: 814-895-7987
  • Fax: 814-944-5375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010352
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: