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General NPI Number Information
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NPI Number | 1710434501
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Entity Type | Organization
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Legal Business Name | BLOOMSBURG FAMILY CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 1000 MARKET ST SUITE 1
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City | BLOOMSBURG
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State | PA
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Zip | 17815-2600
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Country | US
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Telephone | 570-784-2282
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Fax | 570-784-2332
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Provider Business Mailing Address
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Address Line | PO BOX 36
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City | BLOOMSBURG
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State | PA
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Zip | 17815-0036
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Country | US
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Telephone | 570-784-2282
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Fax | 570-784-2332
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ELIZABETH ARDO
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Credential | DC
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Telephone | 570-784-2282
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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 | DC010806
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | DC010806
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License Number State | PA
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