Healthcare Provider Details

I. General information

NPI: 1609902774
Provider Name (Legal Business Name): ALAN B GEWANTER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E STATE ST
DOYLESTOWN PA
18901-4354
US

IV. Provider business mailing address

106 E STATE ST
DOYLESTOWN PA
18901-4354
US

V. Phone/Fax

Practice location:
  • Phone: 215-348-3681
  • Fax:
Mailing address:
  • Phone: 215-348-3681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC002198L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: