MEDICARE: LONDER FAMILY CHIROPRACTIC CENTER

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
1	111N00000X	Chiropractor	DC006531-L	PA

General Provider Information

NPI Number	:	1780013193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONDER FAMILY CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	3000 VALLEY FORGE CIR
Second Line	:	SUITE G-12
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-1110
Country	:	US
Telephone Number	:	610-783-1311
Fax Number	:	610-783-1112

Provider Business Practice Location Address
First Line	:	3000 VALLEY FORGE CIR
Second Line	:	SUITE G-12
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-1110
Country	:	US
Telephone Number	:	610-783-1311
Fax Number	:	610-783-1112

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. IRENE LONDER
Credential	:	D.C.
Telephone Number	:	610-783-1311

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	11/06/2013

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