| Surprise Lake Chiropractic, Inc Pc | |
|
724 Meridian E Ste 1, Milton, WA 98354-9391 | |
| (253) 952-0302 | |
| (253) 952-0307 |
| Full Name | Surprise Lake Chiropractic, Inc Pc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 724 Meridian E Ste 1, Milton, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528843612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Jennie R Bonfiglio |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1659671618 PECOS PAC ID: 1355523408 Enrollment ID: I20110310000223 |
| Mailing Address | Practice Location Address |
|---|---|
| Surprise Lake Chiropractic, Inc Pc Po Box 1166, Puyallup, WA 98371-0228 Ph: (253) 952-0302 | Surprise Lake Chiropractic, Inc Pc 724 Meridian E Ste 1, Milton, WA 98354-9391 Ph: (253) 952-0302 |
Dr. Jennie Bonfiglio, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 724 Meridian E Ste 1, Milton, WA 98354 Phone: 253-952-0302 Fax: 253-952-0307 | |
Dr. Ida M Rogers, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 2748 Milton Way, Ste 211, Milton, WA 98354 Phone: 253-952-0302 Fax: 253-952-0307 |