Organization
BRIDGEPORT FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON EDWARD LABENNE DC (OWNER)
(304) 842-7678
Entity
Organization
Contact information
Practice address
150 EAST PHILADELPHIA AVE, BRIDGEPORT, WV 26330-1520
(304) 842-7678
(304) 842-5973
Mailing address
150 EAST PHILADELPHIA AVE, BRIDGEPORT, WV 26330-1520
(304) 842-7678
(304) 842-5973
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
764
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2204026000
—
WV
Enumeration date
10/16/2006
Last updated
11/12/2014
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