Provider Demographics
NPI:1114216066
Name:BISH CHIROPRACTIC L.L.C
Entity Type:Organization
Organization Name:BISH CHIROPRACTIC L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:BISH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-275-4030
Mailing Address - Street 1:363 BROAD ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:16242-1304
Mailing Address - Country:US
Mailing Address - Phone:814-275-4030
Mailing Address - Fax:814-275-4483
Practice Address - Street 1:363 BROAD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:16242-1304
Practice Address - Country:US
Practice Address - Phone:814-275-4030
Practice Address - Fax:814-275-4483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADCOO5763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty