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General NPI Number Information
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NPI Number | 1164544896
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Entity Type | Individual
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Provider Name | ALEXANDER NICHOLAS BOHATIUK DC
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 811 GOVERNORS PLACE
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City | BEAR
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State | DE
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Zip | 19701
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Country | US
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Telephone | 302-836-8361
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Fax | 302-836-8163
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Provider Business Mailing Address
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Address Line | 811 GOVERNORS PLACE
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City | BEAR
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State | DE
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Zip | 19701
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Country | US
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Telephone | 302-836-8361
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Fax | 302-836-8163
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | F10000281
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC003923L
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License Number State | PA
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