Provider Demographics
NPI:1578621660
Name:HEALTH BRIDGE MANAGEMENT
Entity Type:Organization
Organization Name:HEALTH BRIDGE MANAGEMENT
Other - Org Name:HEALTH BRIDGE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:267-672-1262
Mailing Address - Street 1:PO BOX 914
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19027-7217
Mailing Address - Country:US
Mailing Address - Phone:267-672-1262
Mailing Address - Fax:267-672-1264
Practice Address - Street 1:1216 E HUNTING PARK AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19124-4928
Practice Address - Country:US
Practice Address - Phone:267-672-1262
Practice Address - Fax:267-672-1264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008837111N00000X
PA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty