Healthcare Provider Details

I. General information

NPI: 1114988755
Provider Name (Legal Business Name): HETRICK CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N UNION ST
MIDDLETOWN PA
17057
US

IV. Provider business mailing address

500 N UNION ST
MIDDLETOWN PA
17057
US

V. Phone/Fax

Practice location:
  • Phone: 717-944-2225
  • Fax: 717-944-0932
Mailing address:
  • Phone: 717-944-2225
  • Fax: 717-944-0932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: PAUL R HETRICK JR.
Title or Position: PRESIDENT
Credential: DC
Phone: 717-944-2225