Provider Demographics
NPI:1225112402
Name:BRIDGEWATER CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:BRIDGEWATER CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-828-2355
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:102 E COLLEGE ST
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812
Mailing Address - Country:US
Mailing Address - Phone:540-828-2355
Mailing Address - Fax:540-828-4263
Practice Address - Street 1:102 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:VA
Practice Address - Zip Code:22812
Practice Address - Country:US
Practice Address - Phone:540-828-2355
Practice Address - Fax:540-828-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA317462OtherANTHEM OF VIRGINIA