Provider Demographics
NPI:1073767687
Name:BEAR FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:BEAR FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:260-227-0054
Mailing Address - Street 1:360 N MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-2041
Mailing Address - Country:US
Mailing Address - Phone:260-227-0054
Mailing Address - Fax:
Practice Address - Street 1:360 N MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-2041
Practice Address - Country:US
Practice Address - Phone:260-227-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002402A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty