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General NPI Number Information
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NPI Number | 1215984463
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Entity Type | Individual
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Provider Name | CRAIG C. BROMLEY D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 07/03/2013
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Provider Practice Location Address
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Address Line | 112 J D PARK RD SUITE 4
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City | LEWISBURG
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State | WV
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Zip | 24901-9034
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Country | US
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Telephone | 304-520-4988
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Fax |
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Provider Business Mailing Address
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Address Line | 112 J D PARK RD SUITE 4
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City | LEWISBURG
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State | WV
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Zip | 24901-9034
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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 |
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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 | 38MC00519900
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License Number State | NJ
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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 | DC007362L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 834
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | F1-0000469
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License Number State | DE
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