Healthcare Provider Details

I. General information

NPI: 1841251931
Provider Name (Legal Business Name): DR. CLAYTON J. STITZEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 W ORANGE ST
LITITZ PA
17543-8753
US

IV. Provider business mailing address

504 W ORANGE ST
LITITZ PA
17543-8753
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-3009
  • Fax: 717-627-3330
Mailing address:
  • Phone: 717-627-3009
  • Fax: 717-627-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberDC008875
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC008875
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: