Healthcare Provider Details

I. General information

NPI: 1639143068
Provider Name (Legal Business Name): ROBIN K. MCCONNELL D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 COCOA AVE
HERSHEY PA
17033-1712
US

IV. Provider business mailing address

1106 COCOA AVE
HERSHEY PA
17033-1712
US

V. Phone/Fax

Practice location:
  • Phone: 717-520-1212
  • Fax: 717-520-1221
Mailing address:
  • Phone: 717-520-1212
  • Fax: 717-520-1221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 008970
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberAJ008112
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: