Provider Demographics
NPI:1427260843
Name:PUTNAM, BERN WEBB (DC)
Entity type:Individual
Prefix:DR
First Name:BERN
Middle Name:WEBB
Last Name:PUTNAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:5000 ESTATE ENIGHED
Mailing Address - Street 2:149
Mailing Address - City:ST JOHN
Mailing Address - State:VI
Mailing Address - Zip Code:00830-6120
Mailing Address - Country:US
Mailing Address - Phone:340-693-7100
Mailing Address - Fax:340-693-7100
Practice Address - Street 1:5000 ESTATE ENIGHED
Practice Address - Street 2:149
Practice Address - City:ST JOHN
Practice Address - State:VI
Practice Address - Zip Code:00830-6120
Practice Address - Country:US
Practice Address - Phone:340-693-7100
Practice Address - Fax:340-693-7100
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VI18111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor