Healthcare Provider Details

I. General information

NPI: 1619214608
Provider Name (Legal Business Name): BERKS COUNTY CHIROPRACTIC SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2013
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 HAMPDEN BLVD
READING PA
19604-1010
US

IV. Provider business mailing address

2611 HAMPDEN BLVD
READING PA
19604-1010
US

V. Phone/Fax

Practice location:
  • Phone: 610-921-2030
  • Fax: 610-921-2595
Mailing address:
  • Phone: 610-921-2030
  • Fax: 610-921-2595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010623
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC010623
License Number StatePA

VIII. Authorized Official

Name: DR. SEAN MICHAEL ENGLEHART
Title or Position: MEMBER
Credential: D.C.
Phone: 484-797-5398