Provider Demographics
NPI:1841607454
Name:CHIRONETICS INTERNATIONAL INCORPORATED
Entity Type:Organization
Organization Name:CHIRONETICS INTERNATIONAL INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-847-9936
Mailing Address - Street 1:8794 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:OTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18942-9669
Mailing Address - Country:US
Mailing Address - Phone:610-847-9936
Mailing Address - Fax:610-847-5953
Practice Address - Street 1:8794 EASTON RD
Practice Address - Street 2:
Practice Address - City:OTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18942-9669
Practice Address - Country:US
Practice Address - Phone:610-847-9936
Practice Address - Fax:610-847-5953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty