Provider Demographics
NPI:1730114661
Name:BUNCKE, JONATHAN FRANCIS (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:FRANCIS
Last Name:BUNCKE
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 1:637 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT
Mailing Address - State:PA
Mailing Address - Zip Code:15046-5450
Mailing Address - Country:US
Mailing Address - Phone:412-404-6725
Mailing Address - Fax:412-914-3685
Practice Address - Street 1:533 CARNOT RD
Practice Address - Street 2:
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-2301
Practice Address - Country:US
Practice Address - Phone:412-264-4504
Practice Address - Fax:412-264-4509
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101943096 0001Medicaid
PA065881Medicare PIN