MEDICARE: BAUMAN FAMILY CHIROPRACTIC PC

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	DC009040	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1618705	OTHER	PA	BCBS GROUP

General Provider Information

NPI Number	:	1518098847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAUMAN FAMILY CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	11616 FRANKSTOWN RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-3319
Country	:	US
Telephone Number	:	412-704-5053
Fax Number	:	724-382-7775

Provider Business Practice Location Address
First Line	:	11616 FRANKSTOWN RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-3319
Country	:	US
Telephone Number	:	412-704-5053
Fax Number	:	724-382-7775

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. KELLY A TAYLOR
Credential	:	DC
Telephone Number	:	412-704-5053

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	01/29/2024

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