Healthcare Provider Details
I. General information
NPI: 1346205143
Provider Name (Legal Business Name): DAVID JOHN CHARNEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/18/2006
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3076 EAGLE VALLEY RD.
MILL HALL PA
17751-1626
US
IV. Provider business mailing address
3076 EAGLE VALLEY RD.
MILL HALL PA
17751-1626
US
V. Phone/Fax
- Phone: 570-726-2000
- Fax: 570-726-8012
- Phone: 570-726-2000
- Fax: 570-726-8012
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC009076 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | AJ008899 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: