Healthcare Provider Details

I. General information

NPI: 1700886876
Provider Name (Legal Business Name): HEATH CONDON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 FAIRVIEW AVE
EASTON PA
18042-3915
US

IV. Provider business mailing address

2001 FAIRVIEW AVE
EASTON PA
18042-3915
US

V. Phone/Fax

Practice location:
  • Phone: 610-250-8898
  • Fax: 484-261-9176
Mailing address:
  • Phone: 610-250-8898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC05198
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC007212L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: