Provider Demographics
NPI:1003540428
Name:KERRY V BERTSCHINGER DC
Entity Type:Organization
Organization Name:KERRY V BERTSCHINGER DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:V
Authorized Official - Last Name:BERTSCHINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-263-6953
Mailing Address - Street 1:9763 TUSCARORA PIKE
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-1000
Mailing Address - Country:US
Mailing Address - Phone:304-263-6953
Mailing Address - Fax:304-263-2178
Practice Address - Street 1:9763 TUSCARORA PIKE
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-1000
Practice Address - Country:US
Practice Address - Phone:304-263-6953
Practice Address - Fax:304-263-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty