Provider Demographics
NPI:1427229426
Name:DEMOND, PHILIP BRUCE (D,C,)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:BRUCE
Last Name:DEMOND
Suffix:
Gender:M
Credentials:D,C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S GERALD DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-3217
Mailing Address - Country:US
Mailing Address - Phone:302-994-6477
Mailing Address - Fax:
Practice Address - Street 1:700 KIRKWOOD HWY LIBERTY PLAZA
Practice Address - Street 2:STE 4 2ND FLOOR
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5539
Practice Address - Country:US
Practice Address - Phone:302-994-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000688111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology