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Individual

BRYN ALEXA GILLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
HC 1 BOX 10, BRODHEADSVILLE, PA 18322-9660
(570) 992-2929
(570) 992-3221
Mailing address
HC1 BOX 10, BRODHEADSVILLE, PA 18322-9660
(570) 992-2929
(570) 992-3221

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC007914L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1783617
AMERIHEALTH
PA
01
2622014000
INDEP PERSONAL CHOICE
PA
01
819689
FIRST PRIORITY
PA
01
9701133
GHI
PA
Enumeration date
10/17/2006
Last updated
07/08/2007
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