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NPI Code Detail

MEDICARE: SPRING ROAD WELLNESS & CHIROPRACTIC CENTER, PC

MEDICARE: SPRING ROAD WELLNESS & CHIROPRACTIC CENTER, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC009126PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12030375OTHERHIGHMARK BLUE SHIELD

General Provider Information

NPI Number : 1679748982
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRING ROAD WELLNESS & CHIROPRACTIC CENTER, PC
Provider Business Mailing Address
First Line : 1921 SPRING RD
Second Line :
City : CARLISLE
State : PA
Zip : 17013-1157
Country : US
Telephone Number : 717-241-9355
Fax Number :
Provider Business Practice Location Address
First Line : 1921 SPRING RD
Second Line :
City : CARLISLE
State : PA
Zip : 17013-1157
Country : US
Telephone Number : 717-241-9355
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. LEONARD J KIELBASA
Credential : D.C.
Telephone Number : 717-241-9355
Provider Enumeration Date : 04/28/2008
Last Update Date : 07/21/2008

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1033190772 — SPRING ROAD FAMILY PRACTICE
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CARLISLE, PA
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1609900430 — LEONARD J. KIELBASA, D.C.
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1437358777 — SPRING ROAD FAMILY PRACTICE, INC.
Practice Location Address:
1921 SPRING RD
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17013-1157
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Directions to “SPRING ROAD WELLNESS & CHIROPRACTIC CENTER, PC ” Practice Location

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