Healthcare Provider Details
I. General information
NPI: 1104099530
Provider Name (Legal Business Name): LEHIGH FAMILY CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2008
Last Update Date: 04/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4527 E MAIN ST
BELLEVILLE PA
17004-9227
US
IV. Provider business mailing address
4527 E MAIN ST P.O. BOX 872
BELLEVILLE PA
17004-9227
US
V. Phone/Fax
- Phone: 717-935-5916
- Fax:
- Phone: 717-935-5916
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
COREY
LEHIGH
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 717-935-5916