Individual
JESSE CHARLES BUMBARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
24002 65TH AVE, DOUGLASTON, NY 11362-1921
(814) 553-9784
Mailing address
24002 65TH AVE, DOUGLASTON, NY 11362-1921
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X013612-01
NY
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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