Healthcare Provider Details

I. General information

NPI: 1841520376
Provider Name (Legal Business Name): LANCASTER SPINAL HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberDC008875
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CLAYTON J STITZEL
Title or Position: OWNER
Credential:
Phone: 717-627-3009