Healthcare Provider Details

I. General information

NPI: 1194760306
Provider Name (Legal Business Name): NORMAN R HUERTGEN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 BETHLEHEM PIKE
ERDENHEIM PA
19038-8114
US

IV. Provider business mailing address

711 BETHLEHEM PIKE
ERDENHEIM PA
19038-8114
US

V. Phone/Fax

Practice location:
  • Phone: 215-233-6880
  • Fax: 215-233-2876
Mailing address:
  • Phone: 215-233-6880
  • Fax: 215-233-2876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005334L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: