Healthcare Provider Details

I. General information

NPI: 1053758011
Provider Name (Legal Business Name): SICKMAN CHIROPRACTIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 05/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 COLUMBIA AVE
LANCASTER PA
17603-3156
US

IV. Provider business mailing address

1050 COLUMBIA AVE
LANCASTER PA
17603-3156
US

V. Phone/Fax

Practice location:
  • Phone: 717-392-7518
  • Fax: 717-392-8355
Mailing address:
  • Phone: 717-392-7518
  • Fax: 717-392-8355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC008867
License Number StatePA

VIII. Authorized Official

Name: DR. STEVEN DENNIS CILIENTO
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 717-392-7518