Healthcare Provider Details

I. General information

NPI: 1396718169
Provider Name (Legal Business Name): JOHN C PAMMER III D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 6TH ST
CATASAUQUA PA
18032-2210
US

IV. Provider business mailing address

1104 6TH ST
CATASAUQUA PA
18032-2210
US

V. Phone/Fax

Practice location:
  • Phone: 610-264-3344
  • Fax: 610-264-2081
Mailing address:
  • Phone: 610-264-3344
  • Fax: 610-264-2081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC004888L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: