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General NPI Number Information
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NPI Number | 1245486562
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Entity Type | Organization
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Legal Business Name | BRIDGEWATER CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 99 BRIDGE ST SUITE 1
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City | BEAVER
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State | PA
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Zip | 15009-2956
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Country | US
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Telephone | 724-371-0280
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Fax | 724-888-2458
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Provider Business Mailing Address
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Address Line | 99 BRIDGE ST SUITE 1
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City | BEAVER
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State | PA
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Zip | 15009-2956
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Country | US
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Telephone | 724-371-0280
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Fax | 724-888-2458
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. ROLANDO BELLO JR.
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Credential | D.C.
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Telephone | 305-788-8885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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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 | DC009970
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License Number State | PA
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