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Organization

BANGOR CHIROPRACTIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL THOMAS BAUER D.C. (PRESIDENT)
(610) 588-6199
Entity
Organization

Contact information

Practice address
55 BROADWAY, BANGOR, PA 18013-1706
(610) 588-6199
(610) 588-1497
Mailing address
55 BROADWAY, BANGOR, PA 18013-1706
(610) 588-6199
(610) 588-1497

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC007480L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
617339
HIGHMARK BS
PA
01
7498329
AETNA
PA
Enumeration date
10/26/2006
Last updated
02/23/2012
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