Healthcare Provider Details

I. General information

NPI: 1427038702
Provider Name (Legal Business Name): DENNIS JAMES FITTERER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 E MAPLE ST
PALMYRA PA
17078-2435
US

IV. Provider business mailing address

112 E MAPLE ST
PALMYRA PA
17078-2435
US

V. Phone/Fax

Practice location:
  • Phone: 717-838-2071
  • Fax: 717-838-6116
Mailing address:
  • Phone: 717-838-2071
  • Fax: 717-838-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC1833-0
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: