Provider Demographics
NPI:1164460267
Name:BOMPIANI CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:BOMPIANI CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOMPIANI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-925-9220
Mailing Address - Street 1:403 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15697-1154
Mailing Address - Country:US
Mailing Address - Phone:724-925-9220
Mailing Address - Fax:724-925-3742
Practice Address - Street 1:403 S 3RD ST
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-1154
Practice Address - Country:US
Practice Address - Phone:724-925-9220
Practice Address - Fax:724-925-3742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC0016939-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1309518OtherUMW ID #
PA1004205OtherGATEWAY ID #
PA652726OtherHIGHMARK ID #
PA652726Medicare ID - Type UnspecifiedMEDICARE ID #