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General NPI Number Information
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NPI Number | 1306118781
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Entity Type | Organization
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Legal Business Name | LOGAN VALLEY CHIROPRACTIC
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 3014 PLEASANT VALLEY BLVD SUITE 2
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City | ALTOONA
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State | PA
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Zip | 16602-4491
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Country | US
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Telephone | 814-944-8483
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Fax | 814-944-5375
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Provider Business Mailing Address
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Address Line | 3014 PLEASANT VALLEY BLVD SUITE 2
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City | ALTOONA
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State | PA
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Zip | 16602-4491
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Country | US
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Telephone | 814-944-8483
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Fax | 814-944-5375
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JOSEPH R BUMBARGER
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Credential | D.C.
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Telephone | 814-944-8483
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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 | DC010352
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License Number State | PA
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