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General NPI Number Information
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NPI Number | 1215021449
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Entity Type | Organization
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Legal Business Name | BERGTOLD CHIROPRACTIC CLINIC PA
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 3000 IMMOKALEE RD SUITE #2
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City | NAPLES
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State | FL
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Zip | 34110-1444
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Country | US
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Telephone | 239-593-6788
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Fax | 239-593-6799
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Provider Business Mailing Address
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Address Line | 3000 IMMOKALEE RD STE 2
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City | NAPLES
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State | FL
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Zip | 34110-1444
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Country | US
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Telephone | 239-593-6788
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Fax | 239-593-6799
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JAMES J BERGTOLD
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Credential | DC
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Telephone | 239-593-6788
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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 | CH7760
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License Number State | FL
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