Provider Demographics
NPI:1669525044
Name:STANTON, BERNADETTE CYNTHIA (DC)
Entity type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:CYNTHIA
Last Name:STANTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DUNCANNON
Mailing Address - State:PA
Mailing Address - Zip Code:17020-1620
Mailing Address - Country:US
Mailing Address - Phone:717-834-9059
Mailing Address - Fax:
Practice Address - Street 1:618 N HIGH ST
Practice Address - Street 2:
Practice Address - City:DUNCANNON
Practice Address - State:PA
Practice Address - Zip Code:17020-1620
Practice Address - Country:US
Practice Address - Phone:717-834-9059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003594L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor