Healthcare Provider Details

I. General information

NPI: 1356306344
Provider Name (Legal Business Name): JAMES DEAN SPERTZEL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 N MAIN ST CHIROPRACTIC FITNESS CLINIC
BIGLERVILLE PA
17307-9228
US

IV. Provider business mailing address

23 N MAIN ST PO BOX 293 CHIROPRACTIC FITNESS CLINIC
BIGLERVILLE PA
17307-9228
US

V. Phone/Fax

Practice location:
  • Phone: 717-677-6036
  • Fax: 717-677-9503
Mailing address:
  • Phone: 717-677-6036
  • Fax: 717-677-9503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC002642L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: