Provider Demographics
NPI:1902938798
Name:DOVER FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:DOVER FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-677-1900
Mailing Address - Street 1:820 WALKER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2796
Mailing Address - Country:US
Mailing Address - Phone:302-677-1900
Mailing Address - Fax:302-677-1901
Practice Address - Street 1:820 WALKER RD
Practice Address - Street 2:SUITE A
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2796
Practice Address - Country:US
Practice Address - Phone:302-677-1900
Practice Address - Fax:302-677-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE=========OtherCOVENTRY, PIP, OTHER
DEG01912Medicare ID - Type Unspecified