Provider Demographics
NPI:1164441358
Name:BERGER CHIROPRACTIC WELLNESS CLINIC INC
Entity Type:Organization
Organization Name:BERGER CHIROPRACTIC WELLNESS CLINIC INC
Other - Org Name:ERIC JOSEPH BERGER DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-387-2455
Mailing Address - Street 1:107 E MCMURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2961
Mailing Address - Country:US
Mailing Address - Phone:724-969-1051
Mailing Address - Fax:
Practice Address - Street 1:107 E MCMURRAY RD
Practice Address - Street 2:
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2961
Practice Address - Country:US
Practice Address - Phone:724-969-1051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC8601L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1367834OtherBLUES