Healthcare Provider Details

I. General information

NPI: 1134979784
Provider Name (Legal Business Name): CIC POTTSVILLE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E ARCH ST STE 102
POTTSVILLE PA
17901-2982
US

IV. Provider business mailing address

PO BOX 442
POTTSVILLE PA
17901-0442
US

V. Phone/Fax

Practice location:
  • Phone: 570-622-0809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. GENE LEVINSTEIN
Title or Position: OWNER
Credential: MD
Phone: 610-776-4746