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General NPI Number Information
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NPI Number | 1831317023
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Entity Type | Organization
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Legal Business Name | ESSENTIAL CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 429 STATE ST
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City | ERIE
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State | PA
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Zip | 16501-1135
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Country | US
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Telephone | 814-480-8180
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Fax | 814-480-8182
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Provider Business Mailing Address
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Address Line | 429 STATE ST
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City | ERIE
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State | PA
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Zip | 16501-1135
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Country | US
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Telephone | 814-480-8180
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Fax | 814-480-8182
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. VINCENT BAYER
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Credential | DC
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Telephone | 814-480-8180
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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 | DC009258
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License Number State | PA
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