Provider Demographics
NPI:1891132791
Name:MOUNTAIN VIEW CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-346-6451
Mailing Address - Street 1:112 J D PARK RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 J D PARK RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9034
Practice Address - Country:US
Practice Address - Phone:609-346-6451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV834111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty