Individual provider · Type 1 NPI
Mary Ann Bough, DC
Chiropractor · Bloomington, IN
NPI number
1467447516
Active
Practice location
3901 Hagan St Ste C
Bloomington, IN 47401-8516
Fax (812) 336-7556
Mailing address
5229 W Vernal Pike
Bloomington, IN 47404-9661
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 08001999A (IN) |
Chiropractor: 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.
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About NPI 1467447516
Mary Ann Bough, DC's National Provider Identifier is 1467447516, issued on Sep 14, 2005. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Bloomington, IN. The record was last updated on Jan 30, 2013.