Healthcare Provider Details

I. General information

NPI: 1427340470
Provider Name (Legal Business Name): GENTLE HANDS CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 06/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 E CUMBERLAND ST
LEBANON PA
17042-8118
US

IV. Provider business mailing address

456 E CUMBERLAND ST
LEBANON PA
17042-8118
US

V. Phone/Fax

Practice location:
  • Phone: 717-926-1166
  • Fax: 717-272-2326
Mailing address:
  • Phone: 717-926-1166
  • Fax: 717-272-2326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009034
License Number StatePA

VIII. Authorized Official

Name: DR. RANI HEATHER WADDELL
Title or Position: PRESIDENT/ CHIROPRACTOR
Credential: D.C.
Phone: 717-926-1166