Organization
ENNIS STRAIGHT CHIROPRACTIC CENTER
Active
Other names
Bradley D. Ennis,DC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY D ENNIS DC (PROVIDER)
(814) 404-4046
Entity
Organization
Contact information
Practice address
1526 N ATHERTON ST STE 200, STATE COLLEGE, PA 16803-3041
(814) 237-5220
(412) 291-3381
Mailing address
1526 N ATHERTON ST STE 200, STATE COLLEGE, PA 16803-3041
(814) 353-1217
(412) 291-3381
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03081900
CAPITAL BCBS
PA
01
—
347952
BCBS
PA
Enumeration date
09/24/2019
Last updated
10/14/2019
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