Healthcare Provider Details

I. General information

NPI: 1295134823
Provider Name (Legal Business Name): LEHIGH VALLEY INJURY & WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 W UNION BLVD
BETHLEHEM PA
18018-3934
US

IV. Provider business mailing address

37 W UNION BLVD
BETHLEHEM PA
18018-3934
US

V. Phone/Fax

Practice location:
  • Phone: 610-882-4000
  • Fax: 610-882-4008
Mailing address:
  • Phone: 610-882-4000
  • Fax: 610-882-4008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License NumberPT006125L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC006857L
License Number StatePA

VIII. Authorized Official

Name: EDNA LIZ FELICIANO-FLATTS
Title or Position: OWNER & FOUNDER
Credential:
Phone: 610-802-1768