MEDICARE: BACCELLIERI CHIROPRACTIC LLC

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

General Provider Information

NPI Number	:	1801776018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACCELLIERI CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	2 WILLOW GREEN LN
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-1765
Country	:	US
Telephone Number	:	484-947-7019
Fax Number	:

Provider Business Practice Location Address
First Line	:	687 UNIONVILLE RD STE 1
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-4717
Country	:	US
Telephone Number	:	610-444-2878
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. CARL JACKSON BACCELLIERI
Credential	:	DC
Telephone Number	:	484-947-7019

Provider Enumeration Date	:	09/08/2025
Last Update Date	:	10/24/2025

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