Provider Demographics
NPI:1063417582
Name:NONTE, BERNARD M (DC)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:M
Last Name:NONTE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 S EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3503
Mailing Address - Country:US
Mailing Address - Phone:812-634-2474
Mailing Address - Fax:812-634-6038
Practice Address - Street 1:1450 S EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3503
Practice Address - Country:US
Practice Address - Phone:812-634-2474
Practice Address - Fax:812-634-6038
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN754111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN211350Medicare PIN
INU25096Medicare UPIN