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General NPI Number Information
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NPI Number | 1164234720
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Entity Type | Organization
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Legal Business Name | BRIDGE CHIROPRACTIC NATHAN BEYERL CORPORATION
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 4340 GENESEE AVE STE 201
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City | SAN DIEGO
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State | CA
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Zip | 92117-4940
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Country | US
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Telephone | 858-277-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 4340 GENESEE AVE STE 201
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City | SAN DIEGO
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State | CA
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Zip | 92117-4940
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NATHAN BEYERL
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Credential | DC
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Telephone | 612-385-5872
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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 |
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License Number State |
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