Provider Demographics
NPI:1922395102
Name:BULL FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:BULL FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BULL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-258-5000
Mailing Address - Street 1:107 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELKLAND
Mailing Address - State:PA
Mailing Address - Zip Code:16920-1105
Mailing Address - Country:US
Mailing Address - Phone:814-258-5000
Mailing Address - Fax:
Practice Address - Street 1:107 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ELKLAND
Practice Address - State:PA
Practice Address - Zip Code:16920-1105
Practice Address - Country:US
Practice Address - Phone:814-258-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty