Healthcare Provider Details

I. General information

NPI: 1790152445
Provider Name (Legal Business Name): KB CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2015
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 W MOHLER CHURCH RD
EPHRATA PA
17522-9029
US

IV. Provider business mailing address

27 W MOHLER CHURCH RD
EPHRATA PA
17522-9029
US

V. Phone/Fax

Practice location:
  • Phone: 717-739-0134
  • Fax: 717-738-0136
Mailing address:
  • Phone: 717-739-0134
  • Fax: 717-738-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. EMILY ROSE KOVAL
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 570-466-2953