Provider Demographics
NPI:1164483020
Name:BERGIEL, JULIUS GLENN (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:GLENN
Last Name:BERGIEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 PLEASANT DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1318
Mailing Address - Country:US
Mailing Address - Phone:724-375-2000
Mailing Address - Fax:724-375-2000
Practice Address - Street 1:92 PLEASANT DRIVE
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1318
Practice Address - Country:US
Practice Address - Phone:724-375-2000
Practice Address - Fax:724-375-2000
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001762L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T27059Medicare UPIN
012843Medicare ID - Type Unspecified