Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC1612 | PA |
NPI | 1245232925 |
---|---|
Provider Name | Frank Bergman |
First Address | Fairless Hills, PA 19030-2311 |
Second Address | Levittown, PA 19055-2021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 09/07/2007 |