Provider Demographics
NPI:1588211056
Name:BRIDGE TO WELLNESS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BRIDGE TO WELLNESS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:CONRAD
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-853-7842
Mailing Address - Street 1:2700 W 21ST ST STE 8
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6916
Mailing Address - Country:US
Mailing Address - Phone:814-407-3013
Mailing Address - Fax:883-981-0156
Practice Address - Street 1:2700 W 21ST ST STE 8
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-6916
Practice Address - Country:US
Practice Address - Phone:814-407-3013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center