MEDICARE: MR. STEVEN PAUL BERNAL DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR009963	GA

General Provider Information

NPI Number	:	1336651389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN PAUL BERNAL DC

Provider Business Mailing Address
First Line	:	50 WHITLOCK PL SW
Second Line	:	STE 100
City	:	MARIETTA
State	:	GA
Zip	:	30064-3164
Country	:	US
Telephone Number	:	229-382-3210
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 WHITLOCK PL SW
Second Line	:	STE 100
City	:	MARIETTA
State	:	GA
Zip	:	30064-3164
Country	:	US
Telephone Number	:	229-382-3210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2017
Last Update Date	:	02/03/2021

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