Organization
OPTIMAL SPINE INC
Active
Other names
Adio Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID JAY-BRADLEY WISTORT DC (OWNER)
(717) 993-5388
Entity
Organization
Contact information
Practice address
32 S MAIN ST, STEWARTSTOWN, PA 17363-4003
(717) 993-5388
(717) 993-5388
Mailing address
32 S MAIN ST, STEWARTSTOWN, PA 17363-4003
(717) 993-5388
(717) 993-5388
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC4408L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52578001
CAREFIRST
MD
Enumeration date
11/06/2007
Last updated
11/06/2007
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