Doctor Name: | PAUL W BERGAMINI |
NPI Number: | 1053486480 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | 1220 |
Business Practice Address: | 1543 Bleistein Avenue Cody, WY - 82414 |
Business Phone Number: | 3075874600 |
Business Fax Number: | 3075276949 |
Mailing Address: | Po Box 1403, CODY |
State: | WY |
Postal Code: | 82414 |
Phone Number: | 3075877060 |
Fax Number: | |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 06/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 1220 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |