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General NPI Number Information
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NPI Number | 1023296704
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Entity Type | Organization
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Legal Business Name | BURAK CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | RR 5 BOX 5198A
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9209
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Country | US
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Telephone | 570-422-1446
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Fax | 570-422-1447
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Provider Business Mailing Address
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Address Line | RR 5 BOX 5198A
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9209
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Country | US
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Telephone | 570-422-1446
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Fax | 570-422-1447
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. DAVID B. BURAK
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Credential | D.C.
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Telephone | 570-422-1446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC 003211-L
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License Number State | PA
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