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General NPI Number Information
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NPI Number | 1942373402
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Entity Type | Organization
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Legal Business Name | BOLAND CHIROPRACTIC INC.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 915 N MOUNTAIN RD SUITE C
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City | HARRISBURG
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State | PA
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Zip | 17112-1793
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Country | US
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Telephone | 717-652-5550
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Fax | 717-652-2488
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Provider Business Mailing Address
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Address Line | 915 N MOUNTAIN RD SUITE C
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City | HARRISBURG
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State | PA
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Zip | 17112-1793
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Country | US
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Telephone | 717-652-5550
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Fax | 717-652-2488
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Authorized Official
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Title or Position | INSURANCE SPECIALIST
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Name | ANGEL M MOORE
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Credential |
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Telephone | 717-652-5550
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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 | DC00332L
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License Number State | PA
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